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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
  • 1,711 View
  • 136 Download
AbstractAbstract AbstractSummary 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.
Associations of racial and ethnic discrimination with adverse changes in exercise and screen time during the COVID-19 pandemic in the United States
Tong Xia, Gilbert C. Gee, Jian Li, Xinyue Liu, Jin Dai, Lu Shi, Donglan Zhang, Zhuo Chen, Xuesong Han, Yan Li, Hongmei Li, Ming Wen, Dejun Su, Liwei Chen
Epidemiol Health. 2023;45:e2023013.   Published online January 28, 2023
DOI: https://doi.org/10.4178/epih.e2023013
  • 5,485 View
  • 101 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, a growing prevalence of racial and ethnic discrimination occurred when many Americans struggled to maintain healthy lifestyles. This study investigated the associations of racial and ethnic discrimination with changes in exercise and screen time during the pandemic in the United States.
METHODS
We included 2,613 adults who self-identified as non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, or Hispanic from the Health, Ethnicity, and Pandemic study, a cross-sectional survey conducted among a nationally representative sample of United States adults between October and November 2020. We assessed self-reported racial and ethnic discrimination by measuring COVID-19-related racial and ethnic bias and examined its associations with changes in exercise and screen time using multivariable logistic regression models. We analyzed data between September 2021 and March 2022.
RESULTS
COVID-19-related racial and ethnic bias was associated with decreased exercise time among non-Hispanic Asian (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.13 to 1.89) and Hispanic people (OR, 1.91; 95% CI, 1.32 to 2.77), and with increased screen time among non-Hispanic Black people (OR, 1.94; 95% CI, 1.33 to 2.85), adjusting for age, sex, education, marital status, annual household income, insurance, and employment status.
CONCLUSIONS
Racial and ethnic discrimination may have adversely influenced exercise and screen time changes among racial and ethnic minorities during the COVID-19 pandemic in the United States. Further studies are needed to investigate the mechanisms through which racial and ethnic discrimination can impact lifestyles and to develop potential strategies to address racial and ethnic discrimination as a barrier to healthy lifestyles.
Summary
Key Message
In this study with a nationally representative sample of Americans, we found that racial discrimination during the COVID-19 pandemic was associated with undesired changes in exercise and screen time, particularly among minorities.

Citations

Citations to this article as recorded by  
  • Asian American Women’s Experiences of Discrimination and Health Behaviors during the COVID-19 Pandemic
    Katarina Wang, Alice Guan, Janice Seto, Debora L. Oh, Kathie Lau, Christine Duffy, Esperanza Castillo, Valerie McGuire, Michelle Wadhwa, Clifford G. Tepper, Heather A. Wakelee, Mindy C. DeRouen, Salma Shariff-Marco, Iona Cheng, Scarlett Lin Gomez
    Journal of Immigrant and Minority Health.2023;[Epub]     CrossRef
Prediction of cancer survivors’ mortality risk in Korea: a 25-year nationwide prospective cohort study
Yeun Soo Yang, Heejin Kimm, Keum Ji Jung, Seulji Moon, Sunmi Lee, Sun Ha Jee
Epidemiol Health. 2022;44:e2022075.   Published online September 13, 2022
DOI: https://doi.org/10.4178/epih.e2022075
  • 4,205 View
  • 140 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate the factors affecting cancer survival and develop a mortality prediction model for Korean cancer survivors. Our study identified lifestyle and mortality risk factors and attempted to determine whether health-promoting lifestyles affect mortality.
METHODS
Among the 1,637,287 participants in the Korean Cancer Prevention Study (KCPS) cohort, 200,834 cancer survivors who were alive after cancer diagnosis were analyzed. Discrimination and calibration for predicting the 10-year mortality risk were evaluated. A prediction model was derived using the Cox model coefficients, mean risk factor values, and mean mortality from the cancer survivors in the KCPS cohort.
RESULTS
During the 21.6-year follow-up, the all-cause mortality rates of cancer survivors were 57.2% and 39.4% in men and women, respectively. Men, older age, current smoking, and a history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer were associated with reduced risk. The prediction model discrimination in the validation dataset for both KCPS all-cause mortality and KCPS cancer mortality was shown by C-statistics of 0.69 and 0.68, respectively. Based on the constructed prediction models, when we modified exercise status and smoking status, as modifiable factors, the cancer survivors’ risk of mortality decreased linearly.
CONCLUSIONS
A mortality prediction model for cancer survivors was developed that may be helpful in supporting a healthy life. Lifestyle modifications in cancer survivors may affect their risk of mortality in the future.
Summary
Korean summary
현재 암 생존자의 사망 위험을 평가하는 데 유용한 한국형 암 생존자 사망률 예측 모델은 없습니다. 본 연구에서는 고령, 남성, 현재 흡연, 당뇨병 병력을 포함한 생활양식 요인이 사망의 고위험 요인인 반면, 운동 습관 및 암의 가족력은 사망 위험을 감소시키는 것으로 나타났습니다. 현재 흡연과 운동 습관은 사망 위험에 영향을 미치는 수정 가능한 두 가지 요소로써, 이러한 생활습관 요인으로 구성된 예측모형은 생활습관 교정을 통해 우리나라 암 생존자의 사망률을 낮출 수 있음을 시사합니다.
Key Message
Currently, there is no Korean mortality prediction model for cancer survivors that would be useful in evaluating their risk of mortality. The present study showed that lifestyle factors, including older age, male sex, current smoking, and history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer reduced the risk of mortality. Current smoking and exercise habits are the two modifiable factors that affected the risk of mortality. The prediction model comprising these lifestyle factors implies that the risk of mortality of cancer survivors in Korea can be reduced through lifestyle modification.

Citations

Citations to this article as recorded by  
  • COVID-19 Mortality and Severity in Cancer Patients and Cancer Survivors
    Jae-Min Park, Hye Yeon Koo, Jae-ryun Lee, Hyejin Lee, Jin Yong Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Weight maintenance and gain were significantly associated with lower risk of all-cause and cancer-related mortality in Korean adults who were newly diagnosed with cancer based on the Korean NHIS-HEALS cohort
    Yong-June Kim, Seung Park, Won Tae Kim, Yoon-Jong Bae, Yonghwan Kim, Hee-Taik Kang
    Medicine.2023; 102(47): e36184.     CrossRef
The patterns of lifestyle, metabolic status, and obesity among hypertensive Korean patients: a latent class analysis
Suyoung Kim, Seon Cho, Eun-Hee Nah
Epidemiol Health. 2020;42:e2020061.   Published online August 31, 2020
DOI: https://doi.org/10.4178/epih.e2020061
  • 9,482 View
  • 176 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify latent classes in hypertensive patients based on the clustering of factors including lifestyle risk factors, metabolic risk factors, and obesity in each sex.
METHODS
This cross-sectional study included 102,780 male and 103,710 female hypertensive patients who underwent health check-ups at 16 centers in Korea, in 2018. A latent class analysis approach was used to identify subgroups of hypertensive patients. Multinomial logistic regression was performed to examine the association between latent classes and comorbidities of hypertension.
RESULTS
A four-class model provided the best fit for each sex. The following latent classes were identified: Class I (male: 16.9%, female: 1.7%; high risk of lifestyle behaviors [HB] with metabolic disorders and obesity [MO]), Class II (male: 32.4%, female: 47.1%; low risk of lifestyle behaviors [LB] with MO), Class III (male: 15.3%, female: 1.8%; HB with metabolic disorders and normal weight [MNW]), Class IV (male: 35.5%, female: 49.4%; LB with MNW). Lifestyle patterns in the latent classes were classified as high-risk or low-risk according to smoking and high-risk drinking among male, and presented complex patterns including physical inactivity alone or in combination with other factors, among female. Stage 2 hypertensive or diabetic individuals were likely to belong to classes including obesity (HB-MO, LB-MO) in both sexes, and additionally belonged to the HB-MNW class in male.
CONCLUSIONS
Metabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesity. Hypertensive females need to manage obesity, and hypertensive males need to manage lifestyle risk factors and obesity. Sex-specific lifestyle behaviors are important for controlling hypertension.
Summary
Korean summary
고혈압 환자에서 이질적인 집단을 확인하기 위해, 생활습관, 대사이상 및 비만에 기반한 잠재계층분석을 실시한 결과, 각 성별에서 4개 계층으로 분류되었다. 모든 계층에는 대사이상 상태가 포함되었으며, 고위험 생활습관과 비만(HB-MO), 저위험 생활습관과 비만(LB-MO), 고위험 생활습관과 정상체중(HB-MNW), 저위험 생활습관과 정상체중(LB-MNW)으로 유형화하였다. 생활습관 및 비만 여부와 상관없이 모든 잠재계층에 대사이상 상태가 포함된 점으로 고혈압과 대사상태의 긴밀한 관련성을 확인하였으며, 성별에 따라 이질적인 생활습관 패턴(여성에서는 비만 관리와 남성에서는 비만과 생활습관 개선을 강조)을 확인하였다.

Citations

Citations to this article as recorded by  
  • Patterns of unhealthy behaviours during adolescence and subsequent anxiety and depression in adulthood: a prospective register linkage study of the HUNT survey and health registries
    Annette Løvheim Kleppang, Mario Vianna Vettore, Ingeborg Hartz, Siri Håvås Haugland, Tonje Holte Stea
    International Journal of Behavioral Nutrition and Physical Activity.2023;[Epub]     CrossRef
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    Hye Jin Nam, Ju Young Yoon
    BMC Public Health.2022;[Epub]     CrossRef
  • Analysis of Fruit Consumption and the Korean Healthy Eating Index of Adults Using the 2018 Korea National Health and Nutrition Examination Survey
    Sun A Choi, Sung Suk Chung, Jeong Ok Rho
    Journal of the Korean Society of Food Science and Nutrition.2021; 50(10): 1124.     CrossRef
Associations between a health-promoting lifestyle and quality of life among adults with beta-thalassemia major
Aghbabak Maheri, Roya Sadeghi, Davoud Shojaeizadeh, Azar Tol, Mehdi Yaseri, Mojtaba Ebrahimi
Epidemiol Health. 2016;38:e2016050.   Published online November 15, 2016
DOI: https://doi.org/10.4178/epih.e2016050
  • 15,687 View
  • 324 Download
  • 16 Web of Science
  • 18 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
A health-promoting lifestyle (HPL) is a factor that affects the quality of life (QoL) in patients with beta-thalassemia (β-thalassemia). Due to the lack of studies of this issue, this study aimed to determine the association between HPL and QoL among adults with β-thalassemia.
METHODS
This cross-sectional (descriptive-analytic) study was conducted among 389 adult patients with β-thalassemia in Tehran, Iran. The research instrument included a questionnaire consisting of three parts: demographic items, the Short-Form Health Survey and the Health-Promoting Lifestyle Profile. The data were analyzed using SPSS version 23.0. The results were considered significant at the conventional p<0.05 level.
RESULTS
The mean age of the participants was 30.2±8.3 years. The mean score of the HPL dimensions was 127.28±21.53, and the mean score of the QoL domains was 61.44±23.38. The highest and the lowest mean scores of the HPL dimensions were found for spiritual growth (23.96±5.74) and physical activity (11.32±3.95), respectively. The QoL scores in all three domains (total, physical component summary score, and mental component summary score) were moderate. Health responsibility, physical activity, spiritual growth, and interpersonal relations were significant predictive factors of QoL in adults with β-thalassemia; these four dimensions explained 37.9% of the variance in QoL.
CONCLUSIONS
QoL and HPL were not at acceptable levels among patients with thalassemia. Therefore, educational interventions emphasizing spiritual growth, physical activity, and interpersonal relations are necessary for patients with thalassemia.
Summary

Citations

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  • The Effect of Benson Relaxation Technique on Anxiety and Quality of Life in Patients with Thalassemia Major: A Clinical Trial
    Mahnaz Ghaljeh, Fatemeh Kord Salarzehi, Sajad Salehipour
    Indian Journal of Hematology and Blood Transfusion.2023; 39(4): 557.     CrossRef
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    Cureus.2023;[Epub]     CrossRef
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    Brasanyaa Raveendran, Mohammed Dungarwalla
    BDJ Team.2023; 10(8): 28.     CrossRef
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    G. Piatti, M. Giuditta, D. Consonni, E. Cassinerio, M. D. Cappellini
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    Brasanyaa Raveendran, Mohammed Dungarwalla
    British Dental Journal.2022; 233(11): 931.     CrossRef
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