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Original Articles
Food literacy and its relationship with food intake: a comparison between adults and older adults using 2021 Seoul Food Survey data
Seulgi Lee, Sohyun Park, Kirang Kim
Epidemiol Health. 2023;45:e2023062.   Published online July 3, 2023
DOI: https://doi.org/10.4178/epih.e2023062
  • 2,436 View
  • 116 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study was conducted to examine the differences in food literacy between adults and older adults and the association of food literacy with food group intake.
METHODS
In total, 4,039 participants from the 2021 Survey for Food Consumption in Seoul were included in this study. The intake of whole grains, high-protein foods, total vegetables, vegetables excluding kimchi and pickles, fresh fruits, and milk and dairy products was assessed using a simple food frequency questionnaire. Food literacy was measured using a food literacy measurement questionnaire.
RESULTS
With the exception of milk and dairy, adults had a significantly higher proportion of insufficient food intake than older adults (p<0.001). Both adults and older adults with sufficient food group consumption had higher food literacy scores. Notably, the difference in food literacy scores by level of food intake was highest for fresh fruits (p<0.001). After adjusting for confounding factors affecting food literacy scores, a higher score was associated with a lower probability of having insufficient food intake in all food groups for both adults and older adults. Specifically, those in the highest food literacy score quartile were less likely to have insufficient intake of vegetables (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.28 to 0.43) and fresh fruits (OR, 0.32; 95% CI, 0.24 to 0.43), compared to the lowest quartile.
CONCLUSIONS
Improving food literacy is an important factor for promoting healthy food intake in older adults as well as adults. Therefore, it is necessary to develop intervention programs to work toward this goal.
Summary
Korean summary
건강정보 이해능력(health literacy)은 노인에서 만성질환이나 인지능력과의 관련성이 보고되고 있으나 영양정보 이해능력(food literacy)에 대한 연구는 미비하다. 급변하는 식이 환경에서 식사 및 영양과 관련된 정보를 올바르게 이해하고 판단할 수 있는 영양정보 이해능력은 노인성 질환 예방에 중요하다. 본 연구에서 영양정보 이해능력과 식품군 섭취와의 상관성을 분석한 결과 영양정보 이해능력이 높은 노인이 건강한 식품 섭취 부족 위험이 낮았다. 특히 과일 섭취 부족 위험은 영양정보 이해능력이 높은 노인에서 뚜렷하게 낮았다. 국내 영양정보 이해능력 연구는 초기 단계로 주로 성인 대상으로 연구가 이루어져서 본 연구에서의 결과는 그 의의가 크며, 영양정보 이해능력 향상은 성인과 마찬가지로 노인에서도 건강한 식품 섭취를 위한 중요한 요인으로서 이를 위한 프로그램 개발이 필요할 것으로 사료된다.
Key Message
The study on food literacy among older adults in Korea is significant as previous research has mostly focused on adults. The results showed that older adults with higher food literacy score had lower risk of insufficient food intake as compared with those with lower food literacy score. Specifically, the risk of insufficient fresh fruits intake was the lowest among older adults with higher food literacy score. Therefore, improving food literacy is an important factor for promoting healthy food consumption among older adults.
Non-linear relationship between body mass index and self-rated health in older Korean adults: body image and sex considerations
Seok-Joon Yoon, Jin-Gyu Jung, Soon-Ki Ahn, Jong-Sung Kim, Jang-Hee Hong
Epidemiol Health. 2023;45:e2023061.   Published online June 20, 2023
DOI: https://doi.org/10.4178/epih.e2023061
  • 2,748 View
  • 114 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The purpose of this study was to investigate the association between body mass index (BMI) and self-rated health (SRH) in older adults aged over 65 years while examining the influence of self-perceived body image (SBI) and sex.
METHODS
Raw data were obtained from the Korea Community Health Survey, which included BMI measurements of Koreans aged over 65 years (n=59,628). Non-linear relationships between BMI and SRH were analyzed separately for each sex using restricted cubic splines while controlling for SBI and other confounding variables.
RESULTS
Men showed a reverse J-shaped association, while women showed a J-shaped association between BMI and poor SRH. However, including SBI in the model changed this association for men to an inverted U-shape showing a negative direction, with the highest risk of poor SRH observed in the underweight to overweight range. For women, a nearly linear positive relationship was observed. Regardless of BMI, those who perceived their weight as not “exactly the right weight” had a higher risk of poor SRH than those who perceived their weight as “exactly the right weight” in both men and women. Older men who thought they were much too fat or too thin had similar highest risks of poor SRH, whereas older women who thought they were too thin had the highest risk of poor SRH.
CONCLUSIONS
The findings of this study emphasize the importance of considering sex and body image perceptions when assessing the relationship between BMI and SRH in older adults, especially in men.
Summary
Korean summary
자가 평가 건강 상태 (self-rated health, SRH)와 체질량지수는 각각 건강에 많은 관련이 있는 것으로 밝혀져 있다. 하지만 둘 사이의 관계는 연구마다 다양하게 나타나 있고, 노인들을 대상으로 한 연구도 많지 않다. 노인들은 본인들의 체중을 낮게 평가하는 경향이 있어 둘 사이 관계를 살펴볼 때 자기 인지 체형에 대한 고려가 필요하며, 성별에 따른 영향도 역시 고려해봐야 한다. 본 연구에서는 체질량지수로 파악한 비만의 정도에 관계없이 남성과 여성 모두에서 자기 인지 체형이 정상인 경우에 좋지 않은 SRH를 가질 위험성이 낮았다. 남성에서는 체질량지수와 SRH의 관계가 불분명하게 나타났고 자기 인지 체형이 더 중요한 요인으로 보인다. 한편 여성에서는 체질량지수가 증가함에 따라 SRH도 나빠지는 경향을 보였다. 이에 노인들의 비만과 관련된 교육에 있어서는 자가 인지 체형과 체질량지수를 이용한 비만의 기준에 대해 포함하는 것이 중요하다.
Key Message
Previous research has not fully explored the relationship between BMI, SBI, and SRH in older adults. Our study, using big data, found that the relationships differed between men and women. Those who perceived their weight as ‘exactly the right weight’ had the lowest risk of poor SRH. In men, BMI had a weak effect on SRH, while in women, the risk of poor SRH increased as BMI increased. We recommend that healthcare providers should educate older adults about BMI standards and help them identify their SBI for effective obesity counseling.
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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AbstractAbstract AbstractSummary PDFSupplementary 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.
Systematic Review
The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis
Phei Nie Yau, Clairen Jia Ern Foo, Nicholas Li Jie Cheah, Kar Foong Tang, Shaun Wen Huey Lee
Epidemiol Health. 2022;44:e2022058.   Published online July 12, 2022
DOI: https://doi.org/10.4178/epih.e2022058
  • 7,215 View
  • 275 Download
  • 6 Web of Science
  • 10 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region.
METHODS
A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis.
RESULTS
Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life.
CONCLUSIONS
Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.
Summary
Key Message
Highly common and disabling among older adults in ASEAN region, functional disability limits the ability to carry out activities of daily living, and markedly reduces life quality.

Citations

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  • Association of objectively measured physical activity with incidence disability in older adults with/without social isolation
    Masanori Morikawa, Kenji Harada, Satoshi Kurita, Kazuya Fujii, Chiharu Nishijima, Daisuke Kakita, Hiroyuki Shimada
    Archives of Gerontology and Geriatrics.2024; 120: 105338.     CrossRef
  • Sedentary behavior and the combination of physical activity associated with dementia, functional disability, and mortality: A cohort study of 90,471 older adults in Japan
    Zhen Du, Koryu Sato, Taishi Tsuji, Katsunori Kondo, Naoki Kondo
    Preventive Medicine.2024; 180: 107879.     CrossRef
  • Concentrated disadvantage and functional disability: a longitudinal neighbourhood analysis in 100 US cities
    Daniel Semenza, Ian Silver, Richard Stansfield, Courtney Boen
    Journal of Epidemiology and Community Health.2023; 77(10): 676.     CrossRef
  • Functional disability and associated factors in older adults seen at a primary health care unit
    Paulo José Cortez, Paulo Eduardo Aliaga da Silveira, Beatriz Carvalho, João Vitor Medeiros de Abreu, Yan Lyncon, Gerson Souza Santos, Luciano Magalhães Vitorino
    Geriatrics Gerontology and Aging.2023;[Epub]     CrossRef
  • Suitable ultrasound screening method for older adults with disability to identify low muscle mass
    Huaying Ding, Xia Lin, Sha Huang, Jie Liao, Zhouyu Li, Lanlan Chen, Li Zhu, Yukuan Xie, Qian Nie, Xiaoyan Chen
    Frontiers in Medicine.2023;[Epub]     CrossRef
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    Phong Manh Phi, Long Thanh Giang, Tham Thi Hong Pham
    Frontiers in Public Health.2023;[Epub]     CrossRef
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    Jarson Pedro da Costa Pereira, Alcides da Silva Diniz, Maria Conceição Chaves de Lemos, Cláudia Porto Sabino Pinho Ramiro, Poliana Coelho Cabral
    Geriatrics & Gerontology International.2023; 23(10): 736.     CrossRef
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    Aditi Nath, Dr. Sonali Choudhari
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    Supa Pengpid, Karl Peltzer
    International Journal of Geriatric Psychiatry.2022;[Epub]     CrossRef
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Original Articles
The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database
Seon-Rye Kim, Minkook Son, Yu-Rin Kim
Epidemiol Health. 2022;44:e2022055.   Published online July 5, 2022
DOI: https://doi.org/10.4178/epih.e2022055
  • 6,333 View
  • 322 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis.
METHODS
Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index.
RESULTS
In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities.
CONCLUSIONS
Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.
Summary
Korean summary
만성치주질환을 가진 노인에서 스타틴 복용순응도가 낮은 그룹에 비해 높은 그룹이 뇌졸증 발생위험이 낮았다. 특히 여성과 후기 노인 (85세 이상), 동반 질환을 가진 그룹에서 유의한 차이가 있었다. 따라서 스타틴 복용 순응도를 증대시키기 위한 의료진의 노력이 필요할 것이다.
Key Message
The stroke risk of chronic periodontal disease patients was related to statin medication compliance, and the effect of stroke risk was different in women, the elderly, and comorbidities.

Citations

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  • Association between statin compliance and risk of dementia among patients with chronic periodontitis
    Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
    Oral Diseases.2023;[Epub]     CrossRef
The age-standardized incidence, mortality, and case fatality rates of COVID-19 in 79 countries: a cross-sectional comparison and their correlations with associated factors
Dongui Hong, Sohyae Lee, Yoon-Jung Choi, Sungji Moon, Yoonyoung Jang, Yoon-Min Cho, Hyojung Lee, Sukhong Min, Hyeree Park, Seokyung Hahn, Ji-Yeob Choi, Aesun Shin, Daehee Kang
Epidemiol Health. 2021;43:e2021061.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021061
  • 19,369 View
  • 351 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, crude incidence and mortality rates have been widely reported; however, age-standardized rates are more suitable for comparisons. In this study, we estimated and compared the age-standardized incidence, mortality, and case fatality rates (CFRs) among countries and investigated the relationship between these rates and factors associated with healthcare resources: gross domestic product per capita, number of hospital beds per population, and number of doctors per population.
METHODS
The incidence, mortality, and CFRs of 79 countries were age-standardized using the World Health Organization standard population. The rates for persons 60 years or older were also calculated. The relationships among the rates were analysed using trend lines and coefficients of determination (R<sup>2</sup>). Pearson correlation coefficients between the rates and the healthcare resource-related factors were calculated.
RESULTS
The countries with the highest age-standardized incidence, mortality, and CFRs were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively. The R<sup>2</sup> between the incidence and mortality rates was 0.852 for all ages and 0.945 for those 60 years or older. The healthcare resources-related factors were associated positively with incidence rates and negatively with CFRs, with weaker correlations among the elderly.
CONCLUSIONS
Compared to age-standardized rates, crude rates showed greater variation among countries. Medical resources may be important in preventing COVID-19-related deaths; however, considering the small variation in fatality among the elderly, preventive measures such as vaccination are more important, especially for the elderly population, to minimize the mortality rates.
Summary
Korean summary
국가별 발생률, 사망률, 치명률을 WHO 표준 인구로 연령표준화하였고, 의료자원과 관계된 지표와의 상관관계를 파악하였다. 2021년 4월 6일 기준, 연령표준화 발생률, 사망률, 치명률이 가장 높은 나라는 각각 체코 (10만명당 14,253명), 멕시코 (10만명당 182명), 멕시코 (6.7%)이며, 60세 이상 노인은 사망률과 치명률이 더 높은 것으로 나타났다. 1인당GDP, 인구당 의사 수, 인구당 병상 수는 발생률과 양의 상관관계가, 치명률과는 음의 상관관계가 있었고 노인에게서는 상관관계가 약하게 나타났다. 코로나바이러스감염증-19로 인한 피해를 최소화하기 위해서 의료자원의 투입과 더불어 노인의 감염예방이 중요할 것이다.
Key Message
The incidence, mortality, and case fatality rates of 79 countries were age-standardized using the WHO standard population. The correlations between the rates and the healthcare resource-related factors were investigated. As of April 6, 2021, the countries with the highest age-standardized incidence, mortality, and case fatality rates were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively; the mortality and case fatality rates were higher among the elderly. GDP per capita, number of hospital beds per population, and number of doctors per population were associated positively with incidence rate, and negatively with case fatality rates: the correlations were weaker among the elderly. To minimize the burden caused by COVID-19, preventing the elderly from infection is important as well as supply of medical resources.

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Association between weekly fruit and vegetable consumption and depressive symptoms: results from the Korean Elderly Environmental Panel study
Youjeong Yuk, Chae-Rin Han, Yoonyoung Jang, Yun-Chul Hong, Yoon-Jung Choi
Epidemiol Health. 2021;43:e2021029.   Published online April 20, 2021
DOI: https://doi.org/10.4178/epih.e2021029
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Although previous studies have investigated the correlation between fruit and vegetable consumption and depression, the results remain inconclusive. The present study aimed to investigate the association between weekly fruit and vegetable consumption and depressive symptoms in elderly Koreans.
METHODS
A multiple covariate linear regression analysis was performed using the data of 1,226 elderly individuals ≥ 60 years of age who participated in the Korean Elderly Environmental Panel II study from 2012 to 2014. Depressive symptoms were evaluated using the Korean version of the Short form Geriatric Depression Scale (SGDS-K). Generalized linear mixed-effects models were constructed to analyze the repeated measurements of 305 people who participated in the survey every year.
RESULTS
After adjusting for confounders, SGDS-K scores were negatively associated with the frequency of weekly fruit consumption as follows (β [95% confidence interval; CI]: -0.17 [-0.28 to -0.05], -0.17 [-0.27 to -0.07], -0.42 [-0.54 to 0.29], and -0.33 [-0.44 to -0.21]) for less than 1 time/wk, 1-3 times/wk, 4-6 times/wk, and daily, respectively, compared to no consumption. The SGDS-K scores were also negatively associated with the frequency of vegetable consumption (β [95% CI]: -0.86 [-1.18 to -0.55], -0.18 [-0.35 to -0.01], -0.36 [-0.53 to -0.18], and -0.15 [-0.29 to 0.00]) in the above order, respectively.
CONCLUSIONS
Fruit consumption was inversely associated with depression levels in a dose-dependent manner. Although there was no dose-response relationship between vegetable consumption and the level of depression, it was negatively associated with SGDS-K scores.
Summary
Korean summary
KEEP-II 데이터를 활용하여 한국 노년층의 주간 과일 및 채소 섭취 빈도와 우울증상 간의 상관관계를 알아보았다. 주중 과일을 섭취하는 빈도와 우울증상의 정도 및 우울증 이환 간에서 음의 상관관계가 있었으며 양반응관계가 나타났다. 채소 섭취 빈도의 경우에는 양반응관계가 나타나지 않았으나 채소 섭취 빈도와 우울증상의 정도 간에 음의 상관관계가 있었다.
Key Message
Weekly fruit consumption frequency was inversely associated with the level of depression in a dose-dependent manner in Korean elderly population who participated in KEEP-II study. Although there was no dose-response relationship between vegetable consumption and the level of depression, vegetable consumption frequency was negatively associated with the level of depression.

Citations

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  • Anti-Inflammatory, Antioxidant, and Neuroprotective Effects of Polyphenols—Polyphenols as an Element of Diet Therapy in Depressive Disorders
    Anna Winiarska-Mieczan, Małgorzata Kwiecień, Karolina Jachimowicz-Rogowska, Janine Donaldson, Ewa Tomaszewska, Ewa Baranowska-Wójcik
    International Journal of Molecular Sciences.2023; 24(3): 2258.     CrossRef
  • Genetic and environmental influences on fruit and vegetable consumption and depression in older adults
    Annabel P. Matison, Anbupalam Thalamuthu, Victoria M. Flood, Julian N. Trollor, Vibeke S. Catts, Margaret J. Wright, David Ames, Henry Brodaty, Perminder S. Sachdev, Simone Reppermund, Karen A. Mather
    BMC Geriatrics.2023;[Epub]     CrossRef
  • Longitudinal correlates of fruit and vegetable consumption with depressive symptoms among middle-aged and older adults in South Africa
    Supa Pengpid, Karl Peltzer
    BMC Psychology.2022;[Epub]     CrossRef
Brief Communication
Analysis of the difference in the perinatal mortality rate between white-collar and blue-collar workers in Japan, 1995-2015
Tasuku Okui
Epidemiol Health. 2020;42:e2020069.   Published online November 24, 2020
DOI: https://doi.org/10.4178/epih.e2020069
  • 7,867 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study investigated differences in the perinatal mortality rate between white-collar and blue-collar workers.
METHODS
Data from the “Report of Vital Statistics: Occupational and Industrial Aspects” in Japan covering the period from 1995 to 2015 were used. Five-year maternal age groups from 15-19 years to 45-49 years were analyzed according to work type, and the perinatal mortality rate for each age group and the age-standardized perinatal mortality rate according to maternal age were calculated in each analyzed year. A Bayesian age-period-cohort analysis was used to estimate age, period, and cohort effects for the perinatal mortality rate according to work type. Moreover, the perinatal mortality rate ratios between types of workers were estimated for each age group, period, and cohort.
RESULTS
The estimated perinatal mortality rate ratios of blue-collar to white-collar workers were above 1 in most of the age groups and cohorts. The age effect for the perinatal mortality rate among white-collar workers was the largest in the 15-year to 19-year age group, whereas that among blue-collar workers was the largest in the 45-year to 49-year age group. Furthermore, the estimated perinatal rate ratio between white-collar and blue-collar workers tended to increase with maternal age. The magnitude of the decrease of the cohort effects on the perinatal mortality rate was rather larger in blue-collar workers in the cohorts born between 1946-1950 and 1996-2000.
CONCLUSIONS
The magnitude of the disparity markedly increased with maternal age. Thus, middle-aged blue-collar workers need more prenatal care and preventive measures for perinatal mortality than white-collar workers.
Summary
Original Articles
Comparison between walking and moderate-to-vigorous physical activity: associations with metabolic syndrome components in Korean older adults
Ki-Yong An
Epidemiol Health. 2020;42:e2020066.   Published online October 28, 2020
DOI: https://doi.org/10.4178/epih.e2020066
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The purpose of this study was to compare moderate-to-vigorous physical activity (MVPA) with walking in terms of associations with metabolic syndrome components in Korean older adults.
METHODS
Data on 1,388 older adults (age ≥65 years) from the Korea National Health and Nutrition Examination Survey 2018 were analyzed in this study. MVPA time and walking time per week were used as physical activity variables and blood pressure, waist circumference, glucose, high-density lipoprotein cholesterol, and triglyceride levels were analyzed as metabolic syndrome components. Partial correlations, analysis of covariance, and multinomial logistic regression were used for statistical analysis after adjusting for age, sex, smoking, and alcohol consumption.
RESULTS
High-density lipoprotein cholesterol levels were significantly higher in the low MVPA/high walking and high MVPA/ high walking groups than in the low MVPA/low walking group. Triglyceride levels were significantly lower in the high MVPA/ high walking group than in the low MVPA/low walking and low MVPA/high walking groups. Engaging in <150 min/wk of MVPA increased the likelihood of abnormal blood pressure and metabolic syndrome by 1.81 times and 1.89 times, respectively, compared to ≥150 min/wk of MVPA. Engaging in <180 min/wk of walking raised the likelihood of having abnormal highdensity lipoprotein levels by 1.32 times compared to ≥180 min/wk of walking.
CONCLUSIONS
Not only MVPA but also walking was significantly associated with metabolic syndrome components in Korean older adults. Considering older adults’ preferences and exercise barriers, walking should be considered as an essential component of physical activity guidelines to prevent chronic diseases in older adults.
Summary
Korean summary
현재까지 저강도 신체활동 (걷기)은 중고강도 신체활동에 비해 상대적으로 그 중요성이 간과되어 왔다. 하지만 본 연구는 저강도 신체활동도 중고강도 신체활동 못지 않게 노인들에게서 대사증후군을 예방할 수 있는 중요한 역할을 할 수 있음을 보여준다. 게다가 노인들의 신체적 제약, 부상의 위험, 운동 선호도 등을 감안하면 걷기와 같은 저강도 신체활동은 노인들의 건강유지를 위한 신체활동 권고사항의 필수요소로 고려되어야 함을 제안한다.

Citations

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  • Interactive associations of smoking and physical activity with metabolic syndrome in adult men in Korea
    Minjun Kim, Joonwoong Kim, Inhwan Lee
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Differences in the Correlation between the Built Environment and Walking, Moderate, and Vigorous Physical Activity among the Elderly in Low- and High-Income Areas
    Peng Zang, Fei Xian, Hualong Qiu, Shifa Ma, Hongxu Guo, Mengrui Wang, Linchuan Yang
    International Journal of Environmental Research and Public Health.2022; 19(3): 1894.     CrossRef
  • A Cross-Sectional Study on Self-Perceived Health and Physical Activity Level in the Spanish Population
    Ángel Denche-Zamorano, María Mendoza-Muñoz, Jorge Carlos-Vivas, Laura Muñoz-Bermejo, Jorge Rojo-Ramos, Raquel Pastor-Cisneros, Frano Giakoni-Ramírez, Andrés Godoy-Cumillaf, Sabina Barrios-Fernandez
    International Journal of Environmental Research and Public Health.2022; 19(9): 5656.     CrossRef
  • Hand Grip Strength and Likelihood of Moderate-to-Severe Airflow Limitation in the General Population
    Sunyoung Kim, Hyoung Kyu Yoon, Chin Kook Rhee, Hee-Won Jung, Hyun Lee, Yong Suk Jo
    International Journal of Chronic Obstructive Pulmonary Disease.2022; Volume 17: 1237.     CrossRef
  • The neighbourhood environment and profiles of the metabolic syndrome
    Anthony Barnett, Erika Martino, Luke D. Knibbs, Jonathan E. Shaw, David W. Dunstan, Dianna J. Magliano, David Donaire-Gonzalez, Ester Cerin
    Environmental Health.2022;[Epub]     CrossRef
  • A Non-Randomized Combined Program of Walking and Low-Load Resistance Exercise Improves Cognitive Function and Cardiometabolic Risk Factors in Community-Dwelling Elderly Women
    Jeonghyeon Kim, Seamon Kang, Haeryun Hong, Mingyu Joo, Hyunsik Kang
    Healthcare.2022; 10(10): 2106.     CrossRef
  • Accuracy of steps measured by smartphones-based WeRun compared with ActiGraph-GT3X accelerometer in free-living conditions
    Qinqin Yao, Jing Wang, Yucong Sun, Li Zhang, Shuangyuan Sun, Minna Cheng, Qinping Yang, Siyuan Wang, Ling Huang, Tao Lin, Yingnan Jia
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Associations of Walking Activity With Hypertensive Mediated Organ Damage in Community-Dwelling Elderly Chinese: The Northern Shanghai Study
    Yuyan Lyu, Shikai Yu, Chen Chi, Jiadela Teliewubai, Jue Li, Jacques Blacher, Jun Pu, Yi Zhang, Yawei Xu
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
Gender difference in socioeconomic factors affecting suicidal ideation and suicidal attempts among community-dwelling elderly: based on the Korea Community Health Survey
Jin-Young Jeong
Epidemiol Health. 2020;42:e2020052.   Published online July 13, 2020
DOI: https://doi.org/10.4178/epih.e2020052
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  • 4 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study was performed to explore socioeconomic factors associated with suicidal ideation and suicidal attempts among the local community’s resident elderly.
METHODS
The subjects included 129,277 participants aged 65 years or above of the Korea Community Health Survey conducted in 2013 and 2017. Based on the questions for suicidal ideation and suicidal attempts, the subjects were divided into a no suicidal ideation group (n=111,344), a suicidal ideation group (n=17,487), and a suicidal attempt group (n=446). All analyses were stratified by gender, and a complex sample logistic regression analysis was performed to analyze associated factors. SAS version 9.4 was used for all analyses with a significance level of 0.05.
RESULTS
Common factors associated with suicidal ideation in both genders included marital status, frequency of contact with friends, social activity, and average monthly household income. Economic activity was demonstrated as relevant only to the elderly men subjects. According to the analysis, factors associated with suicidal attempts were the recipients of the National Basic Living Security Act for the elderly men compared to age, frequency of contact with family, frequency of contact with friends, and average monthly household income for the elderly women.
CONCLUSIONS
The study revealed that socioeconomic factors leading to suicidal ideation were similar in the elderly of both genders, while a difference was demonstrated for factors associated with suicidal attempts between the elderly of both genders. It is expected that the results of this study may be used as the basis for screening the local community’s elderly with a high suicidal risk, and in the development of suicide prevention services.
Summary
Korean summary
2013년과 2017년 지역사회건강조사에 참여한 129,277명의 노인을 대상으로 자살시도에 관련된 사회-경제적 요인을 탐색하였다. 분석결과, 남성 노인의 자살시도 관련요인은 국민기초생활수급자, 여성 노인의 자살시도 관련요인은 연령, 가족접촉빈도, 친구접촉빈도, 그리고 월평균가구소득으로 나타났다. 본 결과가 지역사회 거주 노인의 자살 고위험군 선별 및 자살 예방서비스 개발에 기초자료로 활용되기를 기대한다.

Citations

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  • A systematic review of psychosocial protective factors against suicide and suicidality among older adults
    Myung Ki, Sylvie Lapierre, Boeun Gim, Minji Hwang, Minku Kang, Luc Dargis, Myoungjee Jung, Emily Jiali Koh, Brian Mishara
    International Psychogeriatrics.2024; : 1.     CrossRef
  • Body mass index, subjective body shape, and suicidal ideation among community-dwelling Korean adults
    Chae Eun Yong, Young Bum Kim, Jiyoung Lyu
    Archives of Public Health.2021;[Epub]     CrossRef
Associations between chronic conditions and oral health services utilization in older Peruvian adults: a pooled analysis of the Demographic and Health Survey 2015-2017
Diego Azañedo, Diego Chambergo-Michilot, Akram Hernández-Vásquez
Epidemiol Health. 2020;42:e2020023.   Published online April 9, 2020
DOI: https://doi.org/10.4178/epih.e2020023
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to investigate the associations between chronic conditions (CCs) and oral health services utilization (OHSU) within the previous 6 months in older Peruvian adults (defined as those 60 years of age or more according to Peruvian law).
METHODS
An analytical cross-sectional study was performed based on the 2015-2017 Peruvian Demographic and Family Health Survey. Pooled data from 13,699 older adults were analyzed. A logistic regression model was used to analyze the associations between OHSU (dependent variable) and CCs (independent variables). Tobacco consumption, obesity, educational level, age, sex, welfare quintile, area of residence, having health insurance, and natural region of residence were included as covariates in the analysis.
RESULTS
The frequency of OHSU in older adults was 18.5% (95% confidence interval [CI], 17.8 to 19.3). The highest percentage point (%p) differences with regards to OHSU were found between the extreme categories of educational level (higher education vs. none or elementary school: +24.8%p) and welfare quintile (richest vs. poorest: +24.0%p). In the crude model, OHSU was associated with diabetes (odds ratio [OR], 1.46; 95% CI, 1.26 to 1.69), but this association disappeared after adjustment for covariates. Meanwhile, depression decreased the likelihood of OHSU (OR, 0.82; 95% CI, 0.72 to 0.95) in the adjusted model.
CONCLUSIONS
The frequency of OHSU was low in older Peruvian adults. Regarding CCs, we found that depression independently decreased the likelihood of OHSU in the adjusted model. Our results may be useful for the development of policies aimed at achieving greater OHSU in older adults with CCs, especially in those with depression.
Summary
The effects of mental health on recurrent falls among elderly adults, based on Korean Community Health Survey data
Kyung Hee Jo, Jong Park, So Yeon Ryu
Epidemiol Health. 2020;42:e2020005.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020005
  • 12,720 View
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  • 8 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify the effect of mental health on frequency of falls (single and recurrent falls) among elderly adults.
METHODS
Data were drawn from the 2015 Korean Community Health Survey. A chi-square test was conducted to compare differences in fall frequency according to health-related behaviors, chronic diseases, and mental health. Subsequently, multinomial logistic regression analysis was used to identify the effects of mental health on single and recurrent falls based on variables found to be significant in the chi-square test.
RESULTS
Recurrent falls were found to be more risky than single falls. Depression was significantly related to single falls (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.12 to 1.44). Depression (OR, 1.56; 95% CI, 1.38 to 1.76), sleep disorder (5 hours or less: OR, 1.12; 95% CI, 1.02 to 1.23; more than 9 hours: OR, 1.24; 95% CI, 1.07 to 1.44, respectively), and subjective stress (OR, 2.30; 95% CI, 1.90 to 2.78) were significantly related to recurrent falls.
CONCLUSIONS
The study’s findings suggest that specialized fall prevention programs are needed to address different types of falls in elderly adults. To prevent recurrent falls, systematic treatment strategies and rehabilitation training must improve physical function and mental health.
Summary
Korean summary
우리나라 노인에서 정신건강이 낙상에 미치는 영향을 확인하였고, 그 결과 단순낙상은 우울감 경험을 한 경우 낙상발생 위험이 증가했으며, 반복낙상은 우울감을 경험하고, 수면장애가 있으며(수면시간 6시간 미만, 9시간 이상), 주관적 스트레스가 커질수록 낙상 위험이 증가하였다. 최종적으로 노인의 정신건강이 반복낙상에 미치는 영향이 더 큰 것을 확인하였다. 본 연구결과를 통해 낙상 예방 및 관리를 위한 보건사업을 제시하고, 반복낙상자의 정신적/신체적 기능 증진을 위한 치료전략과 재활훈련 계획의 근거자료로 활용할 수 있을 것으로 생각된다.

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  • The understanding and experience of falls among community-dwelling adults aged 50 and over living with mental illness: A qualitative study
    Ling Koh, Lynette Mackenzie, Mandy Meehan, Diane Grayshon, Meryl Lovarini
    Aging & Mental Health.2023; 27(4): 789.     CrossRef
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    Yeong Mi Seo, Eun Sook Lee
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    Vanessa Koh, David B. Matchar, Angelique Chan
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    Matt C. Smith, Jessica O’Loughlin, Vasileios Karageorgiou, Francesco Casanova, Genevieve K. R. Williams, Malcolm Hilton, Jessica Tyrrell
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    Sadaya Misaki, Hiroshi Murayama, Mika Sugiyama, Hiroki Inagaki, Tsuyoshi Okamura, Chiaki Ura, Fumiko Miyamae, Ayako Edahiro, Keiko Motokawa, Shuichi Awata
    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics.2023; 60(4): 364.     CrossRef
  • Joinpoint Regression About Injury Mortality and Hospitalization in Korea
    Hyun Jin Park, Ui Jeong Kim, Won kyung Lee, Bohyun Park, Yoonhee Shin, Seonhwa Lee, Eun Jeong Choi, Nam-eun Kim, Ju Ok Park, Hyesook Park
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  • Association between falls in elderly and the number of chronic diseases and health-related behaviors based on CHARLS 2018: health status as a mediating variable
    Shaoliang Tang, Meixian Liu, Tongling Yang, Chaoyu Ye, Ying Gong, Ling Yao, Yun Xu, Yamei Bai
    BMC Geriatrics.2022;[Epub]     CrossRef
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    Mi Young Kim, Yujeong Kim
    BMC Geriatrics.2022;[Epub]     CrossRef
  • A Machine Learning Approach for the Classification of Falls and Activities of Daily Living in Agricultural Workers
    Hyunmok Son, Jae Woon Lim, Sangbae Park, Byeongjoo Park, Jinsub Han, Hong Bae Kim, Myung Chul Lee, Kyoung-Je Jang, Ghiseok Kim, Jong Hoon Chung
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Individual and regional factors associated with suicidal ideation among Korean elderly: a multilevel analysis of the Korea Community Health Survey
Sang Hee Jeong, Byung Chul Chun
Epidemiol Health. 2019;41:e2019022.   Published online May 26, 2019
DOI: https://doi.org/10.4178/epih.e2019022
  • 10,613 View
  • 271 Download
  • 8 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify the individual and regional characteristics that influence suicidal ideation among the Korean elderly population.
METHODS
Using data collected from the 2013 Korea Community Health Survey, a multilevel analysis was performed to establish an understanding of individual behavioral patterns and regional influences on suicidal ideation.
RESULTS
Among the 77,407 individuals sampled, 11,236 (14.5%) elderly people over 60 years of age experienced suicidal ideation. Among individual factors, age, frequency of communication with friends, religious activity, social activity, leisure activity, trust in neighbors, subjective stress level, depressive symptoms, and subjective health status were significantly associated with suicidal ideation. The results showed that the lower the regional deprivation level, the higher the suicidal ideation odds ratio. In terms of regional size, the most significant effects were found in rural areas.
CONCLUSIONS
This study suggested that suicidal ideation in the elderly is associated with community factors, such as the regional deprivation index, as well as personal factors.
Summary
Korean summary
본 연구는 60세 이상 연령의 개인 요인에 따른 자살 생각에 영향을 미치는 요인과 지역 요인을 모두 반영하여 자살 생각에 영향을 미치는 요인을 파악하는 것으로 지역사회건강조사에 응답한 60대 이상 노인 77,407명 중 11,236(14.5%)명을 표본대상으로 선정하여 노인의 자살생각 가능성과 관련된 개인의 행태와 지역 또는 집단에서 영향력을 파악하기 위한 다수준 분석을 실시하였다. 결과적으로 본 연구는 60세이상의 노인에서 자살 생각에 개인적 요인 뿐 아니라 지역박탈지수와 같은 지역 요인이 관여한다는 점을 시사한다.

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    Changsook Lee, Sun-Young Heo
    Asia Pacific Journal of Social Work and Development.2023; 33(2): 101.     CrossRef
  • Influencing factors of psychological pain among older people in China: A cross-sectional study
    Han Zhou, Dong Han, Haisen Zhou, Xinfeng Ke, Dongdong Jiang
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    Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
    BMC Public Health.2022;[Epub]     CrossRef
  • Evaluation of the accessibility and its equity of the national public-private mix (PPM) program for tuberculosis in South Korea: a multilevel analysis
    Hyunjin Son, Changhoon Kim
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    Chae Eun Yong, Young Bum Kim, Jiyoung Lyu
    Archives of Public Health.2021;[Epub]     CrossRef
  • Depression and quality of life in Brazilian and Portuguese older people communities
    Bruno Araújo da Silva Dantas, Anna Carolyna Vieira Cavalcante, Jéssica Maria Arouca de Miranda, Gislani Acásia da Silva Toscano, Thaiza Teixeira Xavier Nobre, Felismina Rosa Parreira Mendes, Francisco Arnoldo Nunes de Miranda, Eulália Maria Chaves Maia, G
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  • Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China
    Ying Yang, Shizhen Wang, Borui Hu, Jinwei Hao, Runhu Hu, Yinling Zhou, Zongfu Mao
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Review
Impact of pharmacist-led home medicines review services on drug-related problems among the elderly population: a systematic review
Sai Krishna Gudi, Ananth Kashyap, Manik Chhabra, Muhammed Rashid, Komal Krishna Tiwari
Epidemiol Health. 2019;41:e2019020.   Published online May 17, 2019
DOI: https://doi.org/10.4178/epih.e2019020
  • 13,606 View
  • 330 Download
  • 22 Web of Science
  • 23 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
To address and elucidate the impact of pharmacist-led home medicines review (HMR) services on identifying drug-related problems (DRPs) among the elderly population in home care settings.
METHODS
A comprehensive systematic search was performed using electronic scientific databases such as PubMed, Scopus, Embase, and Web of Science for studies published between January 1, 2008 and December 31, 2018, pertaining to HMR services by pharmacists for identifying DRPs.
RESULTS
In total, 4,292 studies were retrieved from the searches, of which 24 were excluded as duplicates. Titles and abstracts were screened for the remaining 4,268 studies, of which 4,239 were excluded due to the extraneous nature of the titles and/or abstracts. Subsequently, 29 full-text articles were assessed, and 19 were removed for lacking the outcome of interest and/or not satisfying the study’s inclusion criteria. Finally, 10 studies were included in the review; however, publication bias was not assessed, which is a limitation of this study. In all studies, pharmacists identified a highly significant amount of DRPs through HMR services. The most common types of DRPs were potential drug-drug interactions, serious adverse drug reactions, need for an additional drug, inappropriate medication use, non-adherence, untreated indications, excessive doses, and usage of expired medications.
CONCLUSIONS
HMR is a novel extended role played by pharmacists. The efficiency of such programs in identifying and resolving DRPs could minimize patients’ health-related costs and burden, thereby enhancing the quality of life and well-being among the elderly.
Summary

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Original Article
Health behaviors and health status of Korean middleaged men by marital status: Korea Community Health Study, 2015
Yongho Jee, Youngtae Cho
Epidemiol Health. 2019;41:e2019019.   Published online May 15, 2019
DOI: https://doi.org/10.4178/epih.e2019019
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  • 2 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Previous studies have shown that marital status is associated with household composition and living arrangements, which partially explain observed differences in health status according to marital status. However, due to the rapid socioeconomic and demographic transformations of the last few decades, the distribution of marital status among middle-aged adults has become more diverse. Therefore, this study aimed to obtain up-to-date information on the associations between marital status and health and to investigate the implications of these findings for conventional explanations of the health effects of marriage.
METHODS
The data for this study were obtained from the 2015 Korean Community Health Study. We compared 4 modifiable lifestyle behaviors—smoking, alcohol consumption, physical activity, and self-rated health status—as outcome variables in association with marital status in Korean middle-aged men (age 40-44) living in Seoul and other regions.
RESULTS
Married men showed the lowest cigarette smoking prevalence and the highest subjective health status both before and after adjusting for education and income. The odds of engaging in vigorous physical activity did not show a major difference before and after adjustment for income and education.
CONCLUSIONS
In married men, the prevalence of cigarette smoking was lowest and subjective health status was highest, similar to previous studies. However, the prevalence of engaging in physical activity was highest in divorced/widowed/separated men. The health behaviors and health status of Korean middle-aged adults should be more closely followed, since they are representative of demographic changes in the Korean population.
Summary
Korean summary
결혼 상태에 따른 건강을 다룬 이전연구에서 가구구성행태 위주의 연구, 기혼자일수록 일관되게 양호한 건강상태를 보인다는 결과들이 많이 보고되었으나 저출산 고령화의 흐름속에 1인 가구가 증가하고 가구 형태가 다양화되면서 기존의 연구결과들이 오늘날에도 유의한지에 따른 연구가 필요하며, 따라서 본 연구에서는 한국 중년 남성들의 결혼여부에 따른 건강상태를 분석하고자 하였다.

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Epidemiol Health : Epidemiology and Health