Journal of Preventive Medicine and Public Health

Original Articles

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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Abstract Summary 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

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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

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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
Social engagement and subjective health among older adults in South Korea: Evidence from the Korean Longitudinal Study of Aging (2006–2018)
Bo Zhao, Ji Eon Kim, Jiyoung Moon, Eun Woo Nam
SSM - Population Health.2023; 21: 101341. CrossRef
Do the various leisure forms have equal effects on mental health? A longitudinal analysis of self-selected leisure activities
Junyi Bian, Zubing Xiang
Frontiers in Public Health.2023;[Epub] CrossRef
Development of a prediction model for the depression level of the elderly in low-income households: using decision trees, logistic regression, neural networks, and random forest
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

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

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334 Download
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Abstract 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

Citations

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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

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Abstract 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

Citations

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Predictive Performance of Pender’s Health Promotion Model for Hypertension Control in Iranian Patients

Fatemeh Gorbani, Hassan Mahmoodi, Parvin Sarbakhsh, Abdolreza Shaghaghi
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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

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Abstract 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 Abstract

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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Abstract 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.

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Yunhwan Lee, Joung Hwan Back, Jinhee Kim, Haewon Byeon, Seihee Kim, Mikyung Ryu
Geriatrics & Gerontology International.2012; 12(3): 515. CrossRef

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