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Original Articles
Gender differences in the association between multimorbidity and depression in older Korean adults: an analysis of data from the National Survey of Older Koreans (2011-2017)
SeoYeon Hwang, Jin Young Nam, Jeong Hyun Ahn, Soojin Park
Epidemiol Health. 2022;44:e2022049.   Published online May 24, 2022
DOI: https://doi.org/10.4178/epih.e2022049
  • 8,694 View
  • 386 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Previous studies have shown that people with multimorbidity have a higher risk of depression than those without multimorbidity. However, few studies have examined the association between depression and multimorbidity in men and women separately. Since the rates of depression and multimorbidity are different in men and women, it is necessary to examine whether gender differences affect their association.
METHODS
This study included 30,138 participants (aged ≥ 65 years) from the National Survey of Older Koreans (2011-2017). Depression was defined using the Korean version of the Geriatric Depression Scale (SGDS-K). Multimorbidity was defined as people who had 2 or more chronic diseases, including arthritis, diabetes, heart disease, hypertension, pulmonary disease, cancer, stroke, or osteoporosis. Multiple logistic regression analysis was performed to determine the association between depression and multimorbidity.
RESULTS
In total, 22.2% and 30.7% of men and women, respectively, had depression. Those with multimorbidity had a higher risk of depression than those without chronic conditions; specifically, the difference in risk among men was greater than that among women. Age was considered a moderator for women. While the effects of pulmonary disease, stroke, and cancer were especially substantial in the integrated analysis, gender differences were observed related to various chronic conditions comorbid with heart disease.
CONCLUSIONS
There are gender differences in the association between multimorbidity and depression among older Korean adults. Therefore, gender-specific care should be provided to reduce depression in older adults with multimorbidity.
Summary
Korean summary
복합만성질환을 가진 남성 노인이 복합만성질환을 가진 여성 노인보다 우울증을 경험할 위험이 높았다. 특히 심장질환을 가진 남성 노인과 여성 노인은 심장질환을 포함한 만성질환의 개수에 따라 우울증 위험에 차이가 있었다. 노인들의 수명 향상을 위해 성별 차이를 고려한 치료 방안과 정책이 마련되어야 한다.
Key Message
Multimorbidity was associated with a high-risk of depression in older Korean adults and the effects of multimorbidity differed by gender.

Citations

Citations to this article as recorded by  
  • Inter- and intrapopulation differences in the association between physical multimorbidity and depressive symptoms
    Haiyang Yu, Yike Zhang, Mengxiao Hu, Bowen Xiang, Sijia Wang, Qing Wang
    Journal of Affective Disorders.2024; 354: 434.     CrossRef
  • Exploring Factors Associated With Resilience and Physical Activity in Older Men and Women Post-Hip Fracture
    Hohyun Seong, Barbara Resnick, Sarah Holmes, Elizabeth Galik, Rachel Blankstein Breman, Richard H. Fortinsky, Shijun Zhu
    Journal of Applied Gerontology.2023;[Epub]     CrossRef
The anatomy of COVID-19 comorbidity networks among hospitalized Korean patients
Eun Kyong Shin, Hyo Young Choi, Neil Hayes
Epidemiol Health. 2021;43:e2021035.   Published online May 7, 2021
DOI: https://doi.org/10.4178/epih.e2021035
  • 11,031 View
  • 381 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We aimed to examine how comorbidities were associated with outcomes (illness severity or death) among hospitalized patients with coronavirus disease 2019 (COVID-19).
METHODS
Data were provided by the National Medical Center of the Korea Disease Control and Prevention Agency. These data included the clinical and epidemiological information of all patients hospitalized with COVID-19 who were discharged on or before April 30, 2020 in Korea. We conducted comorbidity network and multinomial logistic regression analyses to identify risk factors associated with COVID-19 disease severity and mortality. The outcome variable was the clinical severity score (CSS), categorized as mild (oxygen treatment not needed), severe (oxygen treatment needed), or death.
RESULTS
In total, 5,771 patients were included. In the fully adjusted model, chronic kidney disease (CKD) (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.19 to 5.61) and chronic obstructive pulmonary disease (COPD) (OR, 3.19; 95% CI, 1.35 to 7.52) were significantly associated with disease severity. CKD (OR, 5.35; 95% CI, 2.00 to 14.31), heart failure (HF) (OR, 3.15; 95% CI, 1.22 to 8.15), malignancy (OR, 3.38; 95% CI, 1.59 to 7.17), dementia (OR, 2.62; 95% CI, 1.45 to 4.72), and diabetes mellitus (OR, 2.26; 95% CI, 1.46 to 3.49) were associated with an increased risk of death. Asthma and hypertension showed statistically insignificant associations with an increased risk of death.
CONCLUSIONS
Underlying diseases contribute differently to the severity of COVID-19. To efficiently allocate limited medical resources, underlying comorbidities should be closely monitored, particularly CKD, COPD, and HF.
Summary
Korean summary
본 연구는 2019 년 코로나 바이러스 질환 (COVID-19)으로 입원 한 환자의 합병증이 결과 (질병 중증도 또는 사망)와 어떤 관련이 있는지를 동반 질환 네트워크 및 다항 로지스틱 회귀 분석을 통해 분석하였다. 기저 질환은 COVID-19의 중증도 및 사망에 차별적으로 영향을 미친다. 제한된 의료 자원을 효율적으로 활용하기 위해서 환자의 기저 동반 질환 중, 특히 만성 신장 질환 (CKD), 만성 폐쇄성 폐 질환 (COPD), 심부전 (HF)을 더욱 면밀히 모니터링해야 한다.
Key Message
We examined how comorbidities were associated with outcomes (illness severity or death) among hospitalized patients with coronavirus disease 2019 (COVID-19), implementing comorbidity network and multinomial logistic regression analyses. Underlying diseases contribute differently to the severity of COVID-19. To efficiently allocate limited medical resources, underlying comorbidities should be closely monitored, particularly chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and heart failure (HF).

Citations

Citations to this article as recorded by  
  • SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses
    Muhannad Smadi, Melina Kaburis, Youval Schnapper, Gabriel Reina, Patricio Molero, Marc L. Molendijk
    The British Journal of Psychiatry.2023; 223(2): 348.     CrossRef
  • Asthma and COPD as co-morbidities in patients hospitalised with Covid-19 disease: a global systematic review and meta-analysis
    James Patrick Finnerty, A. B. M. Arad Hussain, Aravind Ponnuswamy, Hafiz Gulzeb Kamil, Ammar Abdelaziz
    BMC Pulmonary Medicine.2023;[Epub]     CrossRef
  • The Role of Diabetes and Hyperglycemia on COVID-19 Infection Course—A Narrative Review
    Evangelia Tzeravini, Eleftherios Stratigakos, Chris Siafarikas, Anastasios Tentolouris, Nikolaos Tentolouris
    Frontiers in Clinical Diabetes and Healthcare.2022;[Epub]     CrossRef
Comorbidity network analysis related to obesity in middle-aged and older adults: findings from Korean population-based survey data
Hye Ah Lee, Hyesook Park
Epidemiol Health. 2021;43:e2021018.   Published online March 5, 2021
DOI: https://doi.org/10.4178/epih.e2021018
  • 15,482 View
  • 425 Download
  • 16 Web of Science
  • 16 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We conducted a comorbidity network analysis using data from the seventh Korea National Health and Nutrition Examination Survey to systematically quantify obesity-related comorbidities.
METHODS
The study included 11,712 subjects aged 45 to 80 (5,075 male and 6,637 female). A prevalent disease was defined as a specific disease for which a subject had been diagnosed by a doctor and was being treated. Comorbidity network analysis was performed for diseases with a prevalence of 1% or more, including overweight and obesity. We estimated the observed-to-expected ratio of all possible disease pairs with comorbidity strength and visualized the network of obesity-related comorbidities.
RESULTS
In subjects over 45 years old, 37.3% of people had a body mass index over 25.0 kg/m<sup>2</sup>. The most common prevalent disease was hypertension (42.3%), followed by dyslipidemia (17.4%) and diabetes (17.0%). Overweight and obese subjects were 2.1 times (95% confidence interval, 1.9 to 2.3) more likely to have a comorbidity (i.e., 2 or more diseases) than normal-weight subjects. Metabolic diseases such as hypertension, dyslipidemia, diabetes, and osteoarthritis were directly associated with overweight and obesity. The probability of coexistence for each of those 4 diseases was 1.3 times higher than expected. In addition, hypertension and dyslipidemia frequently coexisted in overweight and obese female along with other diseases. In obese male, dyslipidemia and diabetes were the major diseases in the comorbidity network.
CONCLUSIONS
Our results provide evidence justifying the management of metabolic components in obese individuals. In addition, our results will help prioritize interventions for comorbidity reduction as a public health goal.
Summary
Korean summary
본 연구는 비만 관련 동반질환을 체계적으로 정량화하기 위해, 제7차 (2016-2018) 국민건강영양조사 자료를 이용하여 동반질환 네트워크 분석을 수행하였습니다. 45세 이상 성인에서 비만(체질량지수≥25.0 kg/m2)은 정상체중에 비해 동반질환에 대한 위험이 2.1배 높은 것으로 나타났습니다. 동반질환 네트워크에서는 고혈압과 이상지질혈증이 비만 여성의 주요 질환 이였으며, 이상지질혈증과 당뇨병은 비만 남성의 주요 질환인 것으로 나타났습니다. 본 연구결과는 비만 관련 동반질환 감소를 위한 중재의 우선 순위를 정하는데 도움이 될 것이라고 생각됩니다.
Key Message
We conducted a comorbidity network analysis using data from the seventh (2016-2018) Korea National Health and Nutrition Examination Survey to systematically quantify obesity-related comorbidities. In subjects over 45 years old, obese (body mass index ≥ 25.0 kg/m2) subjects were 2.1 times more likely to have a comorbidity than normal-weight subjects. In the comorbidity network, hypertension and dyslipi¬demia were the major diseases in obese females, and dyslipidemia and diabetes were the major diseases in obese males. Our results will help prioritize interventions for reducing obesity-related comorbidities.

Citations

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  • Metabolically healthy obese individuals are still at high risk for diabetes: Application of the marginal structural model
    Hye Ah Lee, Hyesook Park
    Diabetes, Obesity and Metabolism.2024; 26(2): 431.     CrossRef
  • Comorbidity Patterns in Older Patients Undergoing Hip Fracture Surgery: A Comorbidity Network Analysis Study
    Chiyoung Lee, Sijia Wei, Eleanor S. McConnell, Hideyo Tsumura, Tingzhong (Michelle) Xue, Wei Pan
    Clinical Nursing Research.2024; 33(1): 70.     CrossRef
  • Interaction between depressive symptoms and obesity-related anthropometric measures on multimorbidity among community-dwelling older adults: evidence from India
    Waquar Ahmed, T. Muhammad, CV Irshad
    BMC Public Health.2024;[Epub]     CrossRef
  • Chronic disease and multimorbidity in the Chinese older adults’ population and their impact on daily living ability: a cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS)
    Ye Chen, Huixia Ji, Yang Shen, Dandan Liu
    Archives of Public Health.2024;[Epub]     CrossRef
  • Comorbidity increases the risk of pulmonary tuberculosis: a nested case-control study using multi-source big data
    Bao-Yu Wang, Ke Song, Hai-Tao Wang, Shan-Shan Wang, Wen-Jing Wang, Zhen-Wei Li, Wan-Yu Du, Fu-Zhong Xue, Lin Zhao, Wu-Chun Cao
    BMC Pulmonary Medicine.2024;[Epub]     CrossRef
  • Charting Paths to Recovery: Navigating Traumatic Brain Injury Comorbidities through Graph Theory–Exploring Benefits and Challenges
    Shyam Kumar Sudhakar, Kaustav Mehta
    Brain Organoid and Systems Neuroscience Journal.2024;[Epub]     CrossRef
  • Changes in Clinical Manifestations Due to AFLD Retyping Based on the New MAFLD Criteria: An Observational Study Based on the National Inpatient Sample Database
    Xiaoshan Feng, Ruirui Xuan, Yingchun Dong, Xiaoqin Wu, Yiping Cheng, Zinuo Yuan, Hang Dong, Junming Han, Fang Zhong, Jiajun Zhao, Xiude Fan
    Diagnostics.2023; 13(3): 488.     CrossRef
  • The impact of obesity: a narrative review
    BenjaminChih Chiang Lam, AmandaYuan Ling Lim, SooLing Chan, MabelPo Shan Yum, NatalieSi Ya Koh, EricAndrew Finkelstein
    Singapore Medical Journal.2023; 64(3): 163.     CrossRef
  • Prevalence of comorbidities post mild traumatic brain injuries: a traumatic brain injury model systems study
    Shyam Kumar Sudhakar, Shreya Sridhar, Satvika Char, Kathan Pandya, Kaustav Mehta
    Frontiers in Human Neuroscience.2023;[Epub]     CrossRef
  • BMI trajectories, associations with outcomes and predictors in elderly gastric cancer patients undergoing radical gastrectomy: a prospective longitudinal observation study
    Yinning Guo, Yimeng Chen, Xueyi Miao, Jieman Hu, Kang Zhao, Lingyu Ding, Li Chen, Ting Xu, Xiaoman Jiang, Hanfei Zhu, Xinyi Xu, Qin Xu
    Journal of Cancer Survivorship.2023;[Epub]     CrossRef
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    Jin Suk Ra
    Osong Public Health and Research Perspectives.2023; 14(5): 379.     CrossRef
  • Progression and trajectory network of age-related functional impairments and their combined associations with mortality
    Hui Chen, Binghan Wang, Rongxia Lv, Tianjing Zhou, Jie Shen, Huan Song, Xiaolin Xu, Yuan Ma, Changzheng Yuan
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  • Body-mass index and risk of obesity-related complex multimorbidity: an observational multicohort study
    Mika Kivimäki, Timo Strandberg, Jaana Pentti, Solja T Nyberg, Philipp Frank, Markus Jokela, Jenni Ervasti, Sakari B Suominen, Jussi Vahtera, Pyry N Sipilä, Joni V Lindbohm, Jane E Ferrie
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    Kyung Hwan Jegal, Mi Mi Ko, Bo-Young Kim, Mi Ju Son, Sungha Kim, Alessandro de Sire
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  • Multimorbidity and combined interventions for patients with coronary heart disease in Chinese population: Latent class analysis of a multi-center study
    Yuanyuan Chen, Junru Wu, Yan Tang, Zhengxin Li, Qing Wen, Xuejing Sun, Hong Yuan, Yao Lu, Jingjing Cai
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    Thi-Ngoc Tran, Sanghee Lee, Chang-Mo Oh, Hyunsoon Cho
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Prevalence and comorbidity of common mental disorders and associations with suicidal ideation in the adult population
Yousef Veisani, Fathola Mohamadian, Ali Delpisheh
Epidemiol Health. 2017;39:e2017031.   Published online July 22, 2017
DOI: https://doi.org/10.4178/epih.e2017031
  • 12,752 View
  • 263 Download
  • 15 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Little information exists on the association between comorbidities of mental disorders and suicidal ideation in developing countries. The current study examined the relationship between the presence of comorbid mental disorders and suicidal ideation in the adult population.
METHODS
This cross-sectional study was conducted using the cluster random sampling method in 3 steps. Data were collected from a household assets survey and the self-administered 28-item General Health Questionnaire as first step in screening, and the Persian version of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision was used in the second stage to determine the prevalence of mental disorders. Bivariate and multivariate analysis were used to investigate the associations between mental disorders and suicidal ideation.
RESULTS
Of the 763 participants, 199 (26.1%) had 1 or more mental disorder. Forty-two (71.4%) subjects with comorbidities had a history of suicidal ideation, whereas 59 (7.7%) of all participants had a history of suicidal ideation. We found that major depressive disorder and obsessive-compulsive disorder were the most predictive of suicidal ideation in both sexes. The odds ratio for suicidal ideation associated with having 3 comorbid disorders was 2.70 (95% confidence interval [CI], 1.40 to 14.12) in males and 3.06 (95% CI, 1.25 to 15.22) in females.
CONCLUSIONS
Consistent with pervious data, our results confirmed that mental disorders and comorbidities of mental disorders were important predictors of suicidal ideation. Our findings are very useful for applied intervention programs to reduce the suicide rate in regions in which it is high.
Summary

Citations

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  • Troubles mentaux courants et usage de la force dans la police : intérêts et enjeux
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