Epidemiology and Health

Original Articles

Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging: Seungju lim, Eunyoung Yoo, Ickpyo Hong, Ji-Hyuk Park; Epidemiol Health. 2023;45:e2023098. Published online November 2, 2023; DOI: https://doi.org/10.4178/epih.e2023098

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Abstract Summary PDF: Abstract
OBJECTIVES
Few longitudinal studies have explored age-related differences in the relationship between lifestyle factors and cognitive decline. This study investigated lifestyle factors at baseline that slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals.
METHODS
We conducted an 11-year follow-up that included 6,189 older adults from the Korean Longitudinal Study of Aging, which is a cohort study of community-dwelling older Koreans. Lifestyle factors, including physical activity, social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over 11 years. Latent growth modeling and multi-group analysis were performed.
RESULTS
The influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (-0.05; 95% confidence interval [CI], -0.11 to -0.00, per study wave) accelerated cognitive decline in young-old individuals, whereas frequent participation in SA at baseline (0.02; 95% CI, 0.01 to 0.03, per study wave) decelerated cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated cognitive decline in old-old individuals.
CONCLUSIONS
Cognitive strategies based on modifiable lifestyle factors such as smoking cessation in young-old individuals and frequent SA participation in middle-old age individuals may have great potential for preventing cognitive decline. Because the influence of lifestyle factors varied by age group, age-specific approaches are recommended to promote cognitive health.; Summary

Korean summary
본 연구는 국내 노인인구를 연령대별로 구분하여 연소노인(55-64세), 중고령노인(65-74세), 고령노인(75세+)의 인지저하 기울기를 가속 혹은 감속시키는 라이프스타일 요인을 파악하였다. '흡연'은 연소노인의 인지저하를 가속, '사회활동 참여 빈도'는 중고령노인의 인지저하를 감속시키는 것으로 나타났으며, 고령노인의 경우 유의미한 변수가 나타나지 않았다. 본 결과는 노인의 인지건강에 있어 연령대별 차별화된 라이프스타일 전략이 필요할 것을 시사한다.

Key Message
This study aimed to identify lifestyle factors that accelerate or decelerate the cognitive decline slope in the older population in South Korea, categorized by age groups: young-old adults (55-64), middle-old adults (65-74), and old-old adults (75+). The findings indicated that 'smoking' accelerates cognitive decline in young-old adults, while 'frequency of social activity participation' decelerates cognitive decline in middle-old adults. However, no significant lifestyle variables were identified for old-old adults. These results suggest the necessity of differentiated lifestyle strategies based on age groups for promoting cognitive health in the older population.

Health-adjusted life expectancy according to lifestyle classified by the Yonsei Lifestyle Profile-BREF: Sanghun Nam, Kang-Hyun Park, Ji-Hyuk Park, Ickpyo Hong; Epidemiol Health. 2022;44:e2022095. Published online October 28, 2022; DOI: https://doi.org/10.4178/epih.e2022095

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to investigate health-adjusted life expectancy (HALE) by demographic characteristics (sex, educational achievement, and residential area) according to the lifestyle classifications of the Yonsei Lifestyle Profile-BREF (YLP-BREF).
METHODS
This study included 569 participants aged 55 years or older living in Korea. The YLP-BREF domains were physical activity, activity participation, and nutrition.
RESULTS
Females had a longer HALE (mean±standard deviation, 8.90±5.06 years) in the physical activity domain, while males had a longer HALE in the nutrition domain (9.44±5.91 years). People living in rural areas had longer HALE in physical activity (12.02±5.60 years), activity participation (8.58±4.21 years), and nutrition (11.33±6.43 years). There were no significant differences according to sex or residential area. High school graduates showed the longest HALE (physical activity: 10.38± 6.89; activity participation: 7.64±4.29; nutrition: 9.59±6.40 years). There was a significant difference in educational achievement.
CONCLUSIONS
As people age, the demand for a healthy lifestyle increases. This study attempted to calculate HALE by demographic characteristics according to lifestyle. The results of this study will help inform future research directions for providing a healthy lifestyle.; Summary

Korean summary
본 연구는 Yonsei Lifestyle Profile-BREF(YLP-BREF)의 라이프스타일 분류에 따른 인구통계학적 특성(성별, 주거지역, 학력)에 따른 건강조정수명(Health-Adjusted Life Expectancy; HALE)을 알아보고자 하였다. 본 연구에서 사용한 자료는 한국에 거주하는 55세 이상의 569명이 포함되었으며, YLP-BREF는 신체활동, 활동참여, 영양으로 총 세 영역으로 구성되어 있다. 본 연구 결과, 성별에 따른 건강조정수명은 영양에서 9.44세로 남성이 가장 높았으며, 거주지역은 따른 건강조정수명은 신체활동 영역에서 농촌이 12.02세로 가장높았고, 학력에 따른 건강조정수명은 신체활동 영역에서 고등학교 졸업자가 10.38세로 가장 높았다. 본 연구 결과는 건강한 라이프스타일을 인구통계학적 특성에 따라 제공하기 위한 향후 연구 방향을 제시하는 데 도움이 될 것으로 사료된다.

Key Message
This study investigated Health-Adjusted Life Expectancy (HALE) according to demographic characteristics (sex, residence, educational achievement) according to lifestyle classification of Yonsei Lifestyle Profile-BREF. As a result of this study, the HALE by gender was the highest in nutrition at 9.44 years, and the HALE by residential area was the highest in physical activity at 12.02 years in rural areas, and the HALE by education was in physical activity. , high school graduates had the highest age at 10.38. The results of this study are considered to be helpful in suggesting future research directions for providing a healthy lifestyle.

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