Journal of Preventive Medicine and Public Health

Original Articles

The Effects of Social Activities and Living Arrangements on Cognitive Functions in Middle-aged and Elderly Adults: A Panel Study Using the 2006-2018 Korean Longitudinal Study of Aging: Yoon-Jung Choi, Yun-Chul Hong, Young-Kyung Do; J Prev Med Public Health. 2021;54(6):395-403. Published online October 22, 2021; DOI: https://doi.org/10.3961/jpmph.21.384

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Abstract Summary PDF Supplementary Material

Objectives
Previous studies have shown that participation in social activities (SA) can prevent cognitive decline (CD) and that living arrangements (LA) can affect cognitive function. This study aimed to evaluate the effects of SA and LA on CD, as well as their interactions, using longitudinal data.
Methods
Data were used from the 2006-2018 Korean Longitudinal Study for Aging, which followed 10 254 adults older than 45 years over a 12-year period. CD was defined as a ≥4-point score decrease in the Mini-Mental Status Exam over 2 years. We developed an extended Cox proportional hazards model for time-dependent covariates to estimate the hazard ratio (HR) of CD in 4 groups: (1) socially active and living with others, (2) socially active and living alone, (3) socially inactive and living with others (SILO), and (4) socially inactive and living alone (SILA). The model was stratified by gender and adjusted for important confounders.
Results
The HR of CD was significantly higher in the SILO group in men (HR,1.36; 95% confidence interval [CI], 1.08 to 1.78) and in the SILA group in women (HR, 1.72; 95% CI, 1.08 to 2.75). However, the interaction term for gender was not significant.
Conclusions
Among socially inactive elderly adults, the HR of CD was elevated in men who lived with others and in women who lived alone, although the interaction term for gender was not significant. Socially inactive men who live with others and socially inactive women who live alone are particularly encouraged to participate in SA to prevent CD.

Summary

Korean summary
고령화연구패널조사(KLoSA)(2006-2018)에 참여한 10,254명의 45세 이상 성인을 2년마다 추척하여 생존분석을 이용하여, 사회활동 참여여부와 독거 여부가 인지기능 저하에 미치는 영향을 분석하였다. 인지기능 저하는 2년동안 Mini-Mental Status Exam이 4점 이상 감소한 경우로 정의하였다. 그 결과 사회활동에 참여하지 않으면서 가족과 함께 사는 남성과, 사회활동에 참여하지 않으면서 혼자 사는 여성에서 인지기능 저하의 위험이 증가했다.

Citations

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Eight‐year trajectories and predictors of cognitive function in community‐dwelling Korean older adults with cardiovascular diseases
Youn‐Jung Son, Da‐Young Kim, Yoon‐Gyeong Choi, Eun Young Kim
Journal of Nursing Scholarship.2024; 56(1): 153. CrossRef
ANÁLISE DO ESTADO COGNITIVO DE PESSOAS IDOSAS HOSPITALIZADAS
Heloysa Waleska Soares Fernandes, Bárbara Maria Lopes da Silva Brandão, Tamires Paula Gomes Medeiros, Eduarda Cordeiro D'Oliveira Alves, Luana Rodrigues de Almeida, Rafaella Queiroga Souto
Revista Enfermagem Atual In Derme.2024; 97(4): e024263. CrossRef
Is Formal Social Participation Associated with Cognitive Function in Middle-Aged and Older Adults? A Systematic Review with Meta-Analysis of Longitudinal Studies
Cláudia Cunha, Gina Voss, Renato Andrade, Alice Delerue-Matos
Behavioral Sciences.2024; 14(4): 262. CrossRef
The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults
Eunji Kim, Kiho Sung, Chang Oh Kim, Yoosik Youm, Hyeon Chang Kim
Journal of Preventive Medicine and Public Health.2023; 56(1): 31. CrossRef
Effects of a ‘social activity program that encourages interaction’ on rural older people's psychosocial health: Mixed‐methods research
Mami Kikuchi, Ryuta Onishi, Risa Takashima, Kazuko Saeki, Michiyo Hirano
International Journal of Older People Nursing.2023;[Epub] CrossRef
Green Space, Air Pollution, Weather, and Cognitive Function in Middle and Old Age in China
Lingling Zhang, Ye Luo, Yao Zhang, Xi Pan, Dandan Zhao, Qing Wang
Frontiers in Public Health.2022;[Epub] CrossRef

Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study: Seung Hoon Kim, Minah Park, Sung Hoon Jeong, Sung-In Jang, Eun-Cheol Park; J Prev Med Public Health. 2021;54(5):317-329. Published online August 14, 2021; DOI: https://doi.org/10.3961/jpmph.21.077

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Objectives
The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs).
Methods
Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales.
Results
Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively.
Conclusions
The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.

Summary

Korean summary
2018년 지역사회건강조사를 이용하여 190 365명을 대상으로 가족 중 치매환자 유무 및 치매환자와의 동거여부와 수면의 질 사이의 연관성을 분석하였다. 치매환자와의 동거여부와 상관없이 가족 중 치매환자가 존재하는 것은 낮은 수면의 질과 유의한 연관성이 있었다. 가족 중 치매환자가 있지만 동거하지 않는 가족 구성원의 경우 치매환자가 혼자 살 때 낮은 수면의 질과의 연관성이 가장 높게 나타났다.

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Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2022; 55(2): 173. CrossRef
Association of compliance with COVID-19 public health measures with depression
Ju An Byun, Tae Jun Sim, Tae Yoon Lim, Sung-In Jang, Seung Hoon Kim
Scientific Reports.2022;[Epub] CrossRef

Association Between Atrial Fibrillation and the Risk of Dementia in the Korean Elderly: A 10-Year Nationwide Cohort Study: Min-Ah Nah, Kyeong Soo Lee, Tae-Yoon Hwang; J Prev Med Public Health. 2020;53(1):56-63. Published online January 3, 2020; DOI: https://doi.org/10.3961/jpmph.19.117

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Abstract Summary PDF

Objectives
The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly.
Methods
A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders.
Results
In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants.
Conclusions
Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.

Summary

Korean summary
본 연구에서는 국민건강보험공단 노인표본코호트 자료를 사용하여 심방세동의 유무가 치매의 발생위험과 연관되어 있는지 분석하였다. 잠재적인 교란변수들을 통제하여 분석한 결과 심방세동은 치매(HR 1.12, 95% CI 1.07 to 1.17), 알츠하이머 치매(HR 1.12, 95% CI 1.07 to 1.17), 혈관성 치매(HR 1.10, 95% CI 1.03 to 1.18) 발생과 연관되어 있는 것으로 나타났다. 한 편, 심방세동 환자에서의 항응고제 복용은 치매 발생위험(HR 0.50, 95% CI 0.47 to 0.52)을 감소시키는 것으로 나타났다.

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Effects of risk factors on the development and mortality of early- and late-onset dementia: an 11-year longitudinal nationwide population-based cohort study in South Korea
Min Young Chun, Wonjeong Chae, Sang Won Seo, Hyemin Jang, Jihwan Yun, Duk L. Na, Dongwoo Kang, Jungkuk Lee, Dustin B. Hammers, Liana G. Apostolova, Sung-In Jang, Hee Jin Kim
Alzheimer's Research & Therapy.2024;[Epub] CrossRef
Progressive Memory Decline in a Patient With Atrial Septal Defect: Case Report and Literature Review
Yaw Amo Wiafe, Gordon Manu Amponsah, George Asafu Adjaye Frimpong, Isaac Kofi Owusu
Clinical Medicine Insights: Case Reports.2023; 16: 117954762311767. CrossRef
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Caroline Melo de Sousa, Milena Nunes Alves Sousa, Fabrício Kleber de Lucena Carvalho
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A systematic review and meta‐analysis to determine the effect of oral anticoagulants on incidence of dementia in patients with atrial fibrillation
Mingjie Lin, Wenqiang Han, Jingquan Zhong, Lin Wu
International Journal of Clinical Practice.2021;[Epub] CrossRef
Risk of dementia in patients with atrial fibrillation: Short versus long follow‐up. A systematic review and meta‐analysis
Marco Zuin, Loris Roncon, Angelina Passaro, Cristina Bosi, Carlo Cervellati, Giovanni Zuliani
International Journal of Geriatric Psychiatry.2021; 36(10): 1488. CrossRef
Clinical Utility of the Pathogenesis-Related Proteins in Alzheimer’s Disease
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International Journal of Molecular Sciences.2020; 21(22): 8661. 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

Citations

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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

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

Prevalence Rate of Cognitive Impairment and Dementia Among the Elderly in Busan.: Jung Soon Kim, Su Ill Lee, Ihn Sook Jeong, Young In Chung, In Kyung Hwang, Bong Sook Yih, Min Jeong Kim, Eu Soo Cho, Jin Ho Chun; Korean J Prev Med. 2003;36(1):63-70.

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Abstract PDF: OBJECTIVES
To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. METHODS: Total of 1, 101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. RESULTS: With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. CONCLUSIONS: The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.; Summary

Community Based Cross-sectional Study on the Risk Factors of Dementia among the Elderly in a City.: Ihn Sook Jeong, Jung Soon Kim, Byung Chul Chun, Eu Soo Cho; Korean J Prev Med. 2002;35(4):313-321.

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Abstract PDF: OBJECTIVES
To identify the risk factors of dementia among the elderly in a large city. METHODS: A cross-sectional study was conducted in July 2001, with potential participants selected by stratified two stage cluster sampling of the elderly population of Keumgog dong, Busan. A total of 452 elderly people aged 65 years and over, underwent a two phase diagnostic procedure. Mini-mental State Examination-Korean (MMSE-K) and Samsung Dementia Questionnaire were used for the 1st stage, and the Clinical Dementia Rating Scale (CDR), the Bartel ADL, and IADL Index, the Korean Geriatric Depression Scale (KGDS), the Modified Hatchinski Ischemic Scale (MHIS), and other laboratory tests were used for the 2nd stage. RESUJLTS: Of the 446 participants finally chosen, 45 were confirmed with dementia, and 363 as normal, with the rests not confirmed with dementia or as normal, were excluded from the analysis. According to the logistic regression analysis, the risk of dementia was significantly higher in; people aged 80 and above (OR=4.36, 95% CI=1.97-9.62), illiterate (OR=3.58, 95% CI=1.71-7.46), who had a history of strokes (OR=6.35, 95% CI=2.71-14.87), or who had a history of hyperlipidemia (OR=4.74, 95% CI=1.65-13.61), compared to their counterparts. CONCLUSIONS: These results suggest that efforts to prevent strokes and hyperlipidemia can significantly decrease the risk of dementia.; Summary

Prevalence of Dementia in the Elderly of an Urban Community in Korea .: Dong Hyun Kim, Duk L Na, Byeon Gil Yeon, Yeonwook Kang, Kyung Bok Min, Soo Hyun Lee, Sang Suk Lee, Mi Ra Lee, Ok Jung Pyo, Chan Byung Park, Sunmean Kim, Sang Soo Bae; Korean J Prev Med. 1999;32(3):306-316.

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Abstract PDF: OBJECTIVES
In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. METHODS: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase I, 356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. RESULTS: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12.8%(age-adjusted rate: 13.0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.6-10.4%]). The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. CONCLUSIONS: These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.; Summary

English Abstract

Prevalence and Related Factors of Dementia in an Urban Elderly Population Using a New Screening Method.: Hee Young Shin, Eun Kyung Chung, Jung Ae Rhee, Jin Sang Yoon, Jae Min Kim; J Prev Med Public Health. 2005;38(3):351-358.

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Abstract PDF: OBJECTIVE
Dementia has rapidly increased with the prolongation of life expectancy and aging in Korea. This study was conducted to estimate the prevalence of, and find related factors for, dementia in an urban elderly population, using a newly developed screening method. METHODS: Seven hundred and six people, aged over 65 years-old, in Dong district of Gwangju, Korea, were recruited using stratified cluster sampling, and completed Korean version of Geriatric Mental State Schedule B3 (GMS B3-K), the Korean version of the Community Screening Interview for Dementia (CSID-K) and modified 10 word list-learning from the Consortium to Establish a Registry of Alzheimer's Disease (CERAD). Dementia was diagnosed by an algorithm derived from all three of these measures. RESULTS: The crude and age adjusted prevalence rates of dementia were 13.0 and 11.5%, respectively. Age, education, marital status and a history of cerebrovascular disease were identified as factors related with dementia. CONCLUSIONS: The new instrument, using the GMS B3-K, CSID-K and modified 10 word list-learning from the CERAD, was considered effective as a community screening and diagnostic tool for dementia. The results of this study can also be used to develop a community-based prevention and management system for dementia in the future.; Summary

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