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The Trajectory of Depressive Symptoms Across Years of Community Care Utilization Among Older Adults: A 14-Year Follow-up Study Using the ‘Korean Welfare Panel Survey’
Il-Ho Kim, Cheong-Seok Kim, Min-Hyeok Jeong
J Prev Med Public Health. 2023;56(6):495-503.   Published online October 6, 2023
DOI: https://doi.org/10.3961/jpmph.23.022
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AbstractAbstract AbstractSummary PDF
Objectives
While older adults using community care services are known to be vulnerable for depression, community care utilization (CCU) may help to improve the mental health of these elderly. To date, however, it is much less clear how CCU affects depressive symptoms in the elderly population. This study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea.
Methods
Using the 2006-2019 Korean Welfare Panel Survey, this study is focused on elderly born in 1940 or earlier and selected 3281 persons for baseline interviews in 2006. This consisted of 35 800 person-year observations during a period of 14 years. Panel data analysis were employed to construct years of CCU.
Results
After controlling for covariates, linear term of years using community care was negatively associated with depressive symptoms, but a quadratic term was positively significant. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased. The level of depressive symptoms at the 14th year of using community care remains significantly lower than the level at the outset of its utilization.
Conclusions
This finding implies that CCU could be beneficial for improving mental health among older adults.
Summary
Korean summary
한국복지패널조사(2006-2019년)를 활용하여 지역사회 돌봄서비스의 이용기간(14년 간)에 따른 우울변화궤적을 분석하였다. 분석결과, 지난 14년간 돌봄서비스 이용기간에 따른 우울증상의 궤적은 U자형을 따랐다. 즉 노인은 돌봄서비스를 이용한 첫 해에 가장 높은 우울 수준을 보고하였으며, 이후 9년간 지속적으로 감소하였다가, 점차 증가하는 추세를 보였다.
Key Message
Using the 2006-2019 Korean Welfare Panel Survey, this study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased.
“Leisure Life Satisfaction:” Will It Have a Beneficial Impact on Depression Among Older Adults in Community Care Settings in Korea?
Il-Ho Kim, Cheong-Seok Kim
J Prev Med Public Health. 2022;55(4):398-406.   Published online July 7, 2022
DOI: https://doi.org/10.3961/jpmph.22.160
  • 2,693 View
  • 100 Download
  • 5 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
While the risk of depression is expected to substantially increase among older adults receiving community care, leisure life satisfaction can be regarded as a key component in enhancing the mental health of those receiving community care. However, it is not yet known whether community care utilization increases the risk of depression, or what role is played by leisure life satisfaction in these settings. This study investigated the relationship between community care utilization and depression, as well as the main effect and the moderating role of leisure life satisfaction on the link between community care utilization and depression among older adults.
Methods
This study, using the 2019 Korean Welfare Panel Survey, conducted multiple regression analysis on data from 4494 elderly people aged 65 years or older.
Results
After controlling for potential covariates, older community care recipients were more likely to report symptoms of depression than those who did not receive community care. Meanwhile, leisure life satisfaction was negatively associated with depression in older adults. The test for interaction between community care utilization and leisure life satisfaction revealed that leisure life satisfaction significantly attenuated the link between depression and community care utilization.
Conclusions
The findings of this study imply that leisure life satisfaction could play a meaningful role in improving the mental health of older adults receiving community care. Welfare policies affecting older adults should consider leisure life satisfaction as an important resource for reducing depression in community care settings.
Summary
Korean summary
본 연구는 2019년 한국복지패널조사의 4,494명의 노인들을 대상으로 돌봄노인의 우울 수준과 여가생활 만족의 조절효과를 검증하였다. 연구결과, 돌봄노인의 우울증상이 일반노인에 비하여 유의하게 높았다(p<0.001). 반면 여가생활 만족은 돌봄서비스 이용노인의 우울 증상을 조절하는 효과가 있었다. 이 연구의 결과는 여가생활 만족이 돌봄노인의 정신건강을 향상시키는데 의미 있는 역할을 할 수 있다는 것을 암시한다.

Citations

Citations to this article as recorded by  
  • Leisure and Happiness of the Elderly: A Machine Learning Approach
    Eui-Jae Kim, Hyun-Wook Kang, Seong-Man Park
    Sustainability.2024; 16(7): 2730.     CrossRef
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    Kyu-Min Kim, Jae-Hak Kim, Hyun-Sill Rhee, Bo-Young Youn
    Scientific Reports.2023;[Epub]     CrossRef
  • The Trajectory of Depressive Symptoms Across Years of Community Care Utilization Among Older Adults: A 14-Year Follow-up Study Using the ‘Korean Welfare Panel Survey’
    Il-Ho Kim, Cheong-Seok Kim, Min-Hyeok Jeong
    Journal of Preventive Medicine and Public Health.2023; 56(6): 495.     CrossRef
What Explains Socioeconomic Inequality in Health-related Quality of Life in Iran? A Blinder-Oaxaca Decomposition
Satar Rezaei, Mohammad Hajizadeh, Yahya Salimi, Ghobad Moradi, Bijan Nouri
J Prev Med Public Health. 2018;51(5):219-226.   Published online August 7, 2018
DOI: https://doi.org/10.3961/jpmph.18.012
  • 6,262 View
  • 208 Download
  • 4 Crossref
AbstractAbstract PDF
Objectives
This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran.
Methods
This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups.
Results
The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect.
Conclusions
We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.
Summary

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The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015)
Alexandra Foscolou, Stefanos Tyrovolas, George Soulis, Anargiros Mariolis, Suzanne Piscopo, Giuseppe Valacchi, Foteini Anastasiou, Christos Lionis, Akis Zeimbekis, Josep-Antoni Tur, Vassiliki Bountziouka, Dimitra Tyrovola, Efthimios Gotsis, George Metallinos, Antonia-Leda Matalas, Evangelos Polychronopoulos, Labros Sidossis, Demosthenes B. Panagiotakos
J Prev Med Public Health. 2017;50(1):1-9.   Published online December 19, 2016
DOI: https://doi.org/10.3961/jpmph.16.101
  • 12,048 View
  • 335 Download
  • 32 Crossref
AbstractAbstract PDF
Objectives
By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands.
Methods
From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity.
Results
Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001).
Conclusions
A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
Summary

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Replication of Early B-cell Factor 1 (EBF1) Gene-by-psychosocial Stress Interaction Effects on Central Adiposity in a Korean Population
Hyun-Jin Kim, Jin-Young Min, Kyoung-Bok Min
J Prev Med Public Health. 2016;49(5):253-259.   Published online July 10, 2016
DOI: https://doi.org/10.3961/jpmph.16.028
  • 9,962 View
  • 157 Download
  • 2 Crossref
AbstractAbstract PDF
Objectives
Central obesity plays a major role in the development of many chronic diseases, including cardiovascular disease and cancer. Chronic stress may be involved in the pathophysiology of central obesity. Although several large-scale genome-wide association studies have reported susceptibility genes for central adiposity, the effects of interactions between genes and psychosocial stress on central adiposity have rarely been examined. A recent study focusing on Caucasians discovered the novel gene , which was associated with central obesity-related traits via interactions with stress levels. We aimed to evaluate EBF1 gene-by-stress interaction effects on central adiposity traits, including visceral adipose tissue (VAT), in Korean adults.
Methods
A total of 1467 Korean adults were included in this study. We selected 22 single-nucleotide polymorphisms (SNPs) in the EBF1 gene and analyzed their interactions with stress on central adiposity using additive, dominant, and recessive genetic modeling.
Results
The four SNPs that had strong linkage disequilibrium relationships (rs10061900, rs10070743, rs4704967, and rs10056564) demonstrated significant interactions with the waist-hip ratio in the dominant model (pint<0.007). In addition, two other SNPs (rs6556377 and rs13180086) were associated with VAT by interactions with stress levels, especially in the recessive genetic model (pint<0.007). As stress levels increased, the mean values of central adiposity traits according to SNP genotypes exhibited gradual but significant changes (p<0.05).
Conclusions
These results suggest that the common genetic variants for EBF1 are associated with central adiposity through interactions with stress levels, emphasizing the importance of managing stress in the prevention of central obesity.
Summary

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    Michael J. Griffin
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Gender Differences in Hypertension Control Among Older Korean Adults: Korean Social Life, Health, and Aging Project
Sang Hui Chu, Ji Won Baek, Eun Sook Kim, Katherine M. Stefani, Won Joon Lee, Yeong-Ran Park, Yoosik Youm, Hyeon Chang Kim
J Prev Med Public Health. 2015;48(1):38-47.   Published online January 14, 2015
DOI: https://doi.org/10.3961/jpmph.14.043
  • 10,928 View
  • 135 Download
  • 3 Crossref
AbstractAbstract PDF
Objectives
Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients’ attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults.
Methods
This cross-sectional study analyzed data from 653 Koreans aged ≥60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension.
Results
Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one’s blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013).
Conclusions
This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.
Summary

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Use of Senior Center and the Health-Related Quality of Life in Korean Older Adults
Hyun-Shik Kim, Kazuhiro Harada, Masashi Miyashita, Eun-A Lee, Jin-Kee Park, Yoshio Nakamura
J Prev Med Public Health. 2011;44(4):149-156.   Published online July 29, 2010
DOI: https://doi.org/10.3961/jpmph.2011.44.4.149
  • 10,301 View
  • 86 Download
  • 16 Crossref
AbstractAbstract PDF
Objective

The purpose of the present study was to examine the relationship between the use of senior center and health-related quality of life in Korean older adults.

Methods

A questionnaire survey was conducted to two types of older adults who lived in Busan, Korea: 154 older adults who used a senior center and 137 older adults who did not use a senior center. The Korean version of short-form 36-item health survey was administered to assess the health-related quality of life. Demographic variables were obtained from a questionnaire. These were gender, age, family status, marital status, education, monthly income, present illness, body mass index and physical activity.

Results

The 8-domain scales of physical function and role-physical were significantly higher in the users of the senior center compared with the non-users (F=4.87, p=0.027 and F=7.02, p=0.009, respectively). The 8-domain scales of vitality was also significantly higher in the users of the senior center compared with the non-users (F=7.48, p=0.007).

Conclusions

The present study showed that the users of the senior center have higher physical function, role-physical and vitality compared with the non-users. These findings suggest that although the results are unable to specify causal relationships using the senior center may lead to some improvement in health-related quality of life.

Summary

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English Abstracts
Suggestions for Increasing Physical Activity Levels of Korean Older Adults: A Public Health Perspective.
Seung Youn Hong
J Prev Med Public Health. 2010;43(4):362-365.
DOI: https://doi.org/10.3961/jpmph.2010.43.4.362
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  • 66 Download
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AbstractAbstract PDF
2010 is the year when the Korean baby boomer generation faces retirement. With the need for affective strategies to keep this population healthy, the government has placed much effort to increase the regular physical activity (PA) level of older adults. Yet the prevalence of active seniors is still relatively low. This paper reviews the recent government strategies and efforts to enhance the physical activity levels of older adults and the PA programs provided in the community settings by major organizations and institutions. In addition, the problems of the current approaches are shown, and based on a review, the author provides five suggestions for promoting the PA level of older adults as follows. First, specific physical activity goals and objectives for older adults should be included in the National Health Plan 2020. Second, the recommendations for PA for seniors, which include a proper intensity, duration and frequency of exercise, should be provided. Third, the role of organizations and institutions should be rearranged for the proper dissemination of government provided community-based exercise programs. Fourth, a standard quality-control system should be provided, and finally, an evidence-based exercise program, which should be specifically created for the older Korean population, should be developed. Physical activity offers opportunities for people to extend the years of their active independent life and reduce functional limitations. To maximize the effects of government efforts to promote PA for seniors, we feel the comments provided in this paper should be closely examined.
Summary

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  • Clustering of multiple healthy lifestyles among older Korean adults living in the community
    Yunhwan Lee, Joung Hwan Back, Jinhee Kim, Haewon Byeon, Seihee Kim, Mikyung Ryu
    Geriatrics & Gerontology International.2012; 12(3): 515.     CrossRef
Associated Factors of Impaired Fasting Glucose in Some Korean Rural Adults.
Hye Eun Yun, Mi Ah Han, Ki Soon Kim, Jong Park, Myeng Guen Kang, So Yeon Ryu
J Prev Med Public Health. 2010;43(4):309-318.
DOI: https://doi.org/10.3961/jpmph.2010.43.4.309
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AbstractAbstract PDF
OBJECTIVES
This study was performed to investigate the prevalence of impaired fasting glucose (IFG) and its related characteristics among healthy adults in some Korean rural areas. METHODS: We conducted a cross-sectional study using the data from 1352 adults who were over the age 40 and under the age 70 and who were free of diabetes mellitus (DM), cardiovascular diseases and other diseases and who participated in a survey conducted as part of the Korean Rural Genomic Cohort Study. IFG was defined as a serum fasting glucose level between 100 and 125 mg/dL. RESULTS: The prevalence of IFG was 20.4% in men, 15.5% in women and 12.7% overall. Multivariate logistic regression analysis demonstrated that the independent risk factors for IFG were male gender, having a family history of DM, the quartiles of gamma glutamyltransferase and high sensitive C-reactive protein and the waist circumference. The homeostatis model assessment for insulin resistance was very strongly associated with IFG. The prevalence of metabolic syndrome (MS) and MS components was higher in the subjects with IFG then in those with normal fasting glucose (NFG). CONCLUSIONS: The result of study could supply evidence to find the high risk population and to determine a strategy for treating IFG. Further research is needed to explain the causal relationship and mechanisms of IFG.
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  • Classification of Type 2 Diabetes Incidence Risk and the Health Behavior of the 30–50-Year-Old Korean Adults: Latent Class Analysis
    Roma Seol, Jin-Ho Chun
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Prevalence of Hyperhomocysteinemia and Related Factors in a Community-based Health Examination Survey: A Cross-sectional Study.
Soo Jeong Kim, Kyung Sook Lim, Mi Sook Song, Yeonji Kang, Soon Young Lee
J Prev Med Public Health. 2009;42(5):337-342.
DOI: https://doi.org/10.3961/jpmph.2009.42.5.337
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AbstractAbstract PDF
BACKGROUND
Many previous studies have shown that elevated homocysteine in the serum is a well known risk factor for cardiovascular disease and this is associated with other risk factors for cardiovascular disease, but any Korean data on this is limited. OBJECTIVES: This study aimed to calculate the prevalence of hyperhomocysteinemia and to analyze the relation between elevated homocysteine and the lifestyle factors of Korean adults. METHODS: We conducted a cross-sectional survey that included 650 men and 743 women (age range, 20 to 79 years) who were residents of Gwangju City in Gyeonggi-do. These subjects participated in the health interview and examination survey from November to December 2005. The total homocysteine, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride in the serum were measured. All the participants had their body composition measured such as height and weight, and we obtained health-related behavioral information through the self-entry questionnaire. RESULTS: Very right-handed skewed distributions of homocysteine were shown in men and women. The prevalence of hyperhomocysteinemia was 22.6% in men and 13.7% in women in Gwangju city. On the multiple logistic regression analysis, hyperhomocysteinemia was associated with age (OR=1.02, 95% CI=1.01-1.04), male gender (OR=1.60, 95% CI=1.02-2.52), severe general physical activity (OR=0.32, 95% CI=0.15-0.69) and nutrient consumption (OR=0.49, 95% CI=0.31-0.76). CONCLUSIONS: There is a great prevalence of hyperhomocysteinemia in adults of Gwangju City, Korea and it was associated with both genetic factors and lifestyle risk factors. This study can suggest that comprehensive lifestyle modification is needed in order to diminish the prevalence of hyperhomocysteinemia and to prevent CVD.
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    Tae Kyung Yoo, Hye Chang Rhim, Yong-Taek Lee, Kyung Jae Yoon, Chul-Hyun Park
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Health-related Quality of Life Assessment by the EuroQol-5D in Some Rural Adults.
Mi Ah Han, So Yeon Ryu, Jong Park, Myung Geun Kang, Jong Ku Park, Ki Soon Kim
J Prev Med Public Health. 2008;41(3):173-180.
DOI: https://doi.org/10.3961/jpmph.2008.41.3.173
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  • 70 Download
  • 36 Crossref
AbstractAbstract PDF
OBJECTIVES
The purposes of this study were to examine the health-related quality of life(HRQoL) and to identify its related factors for a group of rural adults. METHODS: The study subjects were 1,901 adults who were aged 40-70 years and who were living in Naju City, Jeollanamdo. The sociodemographic characteristics, health-related behavior, health status and global self-rated health were collected for statistical analysis. The healthrelated quality of life was measured by the Euroqol EQ-5D instrument. The differences on the EQ-5D index between the groups were assessed with t-test, ANOVA and hierarchical multiple regression analysis. RESULTS: Overall, the mean value of the EQ-5D index was 0.884+/-0.140 and this score was significantly different according to the socioeconomic characteristics, the healthrelated behavior, the health status and the global self-rated health. According to the results from the hierarchical multiple regression analysis, the HRQoL was significantly reduced for females, older subjects, and other subjects with no spouse and the subjects with osteoporosis, obesity, mental distress or poorer global self-rated health. CONCLUSIONS: The HRQoL for rural adults was related to the socioeconomic characteristics, the health status and the global self-rated health. A better understanding of the factors related to the HRQoL would help to improve the rural adults' quality of life.
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JPMPH : Journal of Preventive Medicine and Public Health