Purpose: The purpose of this study is to investigate the association between unmet healthcare needs due to financial reasons and catastrophic health expenditures. Methods: This study used secondary data from the 2014~2015 Korean Health Panel survey. The subjects of this study were 21,495 people aged 20 or older, and of them, there were 16,227 people aged 20 to 64 and 5,268 people aged 65 or older, which were surveyed between 2014 and 2015. The association between unmet healthcare needs due to financial reasons and catastrophic health expenditures was analyzed through logistic regression. Results: In 2015, 1.7% of people aged 20~64 years and 7.9% of those aged 65 or older experienced unmet healthcare needs due to financial reasons. In the 20~64 age group, people who repeatedly experienced catastrophic health expenditures (=10%,=20%) were less likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=0.50, OR=0.41). However, in the 65-or-older group, people who repeatedly experienced catastrophic health expenditures (=20%) were more likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=1.68). Conclusion: A greater percentage of the elderly repeatedly faced both catastrophic health expenditures and unmet healthcare needs due to financial reasons compared to the non-elderly.
Purpose: The purpose of this study is to identify risk factors of accidental falls by age in the Korean elderly. Methods: The study subjects included 10,242 community-dwelling elders aged 65 or over. The data were analyzed by logistic regression analysis. Results: The risk factors of accidental falls in the younger old group (aged 65~74) include fear of falling (OR=16.28, 95% CI: 12.03~22.03), depression (OR=1.24, 95% CI: 1.06~1.44), and hearing impairment (OR=1.20, 95% CI: 1.01~1.43). The risk factors of accidental falls in the older old group (aged 75~84) include fear of falling (OR=11.54, 95% CI: 7.04~18.93), muscle strength (OR=1.36, 95% CI: 1.15~1.60), number of chronic disease (OR=1.65, 95% CI: 1.09~2.50), and presence of spouse (OR=1.27, 95% CI: 1.06~1.51). The risk factors of accidental falls in the oldest old group (aged 85 years old or older) include fear of falling (OR=8.05, 95% CI: 1.85~34.98) and exercise (OR=2.91, 95% CI: 1.36~6.24). Fear of falling is defined as a common factor in the all age groups. Conclusion: Different strategies should be developed for age groups to prevent elderly falls with understanding of contributing factors of falls in each group.
Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.
Journal of agricultural medicine and community health
/
v.46
no.2
/
pp.67-77
/
2021
Objectives: This study aimed to identify the vaccination rate for pneumococcus among aged 65 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The population of this study was aged 65 or older, with a total of 1,150 subjects to be analyzed and a computer assisted telephone interviewing was used. The survey included pneumococcal vaccination status, reasons of vaccination, sources of information on vaccination, reasons for not vaccination, and other related factors. Results: The vaccination rate for pneumococcus among aged 65 or older was 56.2 percent, lower than 69.0 percent in the U.S. (2017), and 69.2 percent in the U.K. (2019). Among the factors related to the pneumococcal vaccination, the groups with the high vaccination rate were women, low age groups, residents of urban areas, people without a job, people with high education, medical insurance subscribers, married people, and people who have family members. In addition, the groups with high vaccination rates were those with high awareness, those who received recommendations from doctors, those who had vaccination records, those who believed in vaccination effects, and those who saw public service advertisements. Conclusions: In the future, it is necessary to develop alternatives to accurately manage vaccination records for adults who are not eligible for state support, and regular adult vaccination rates should be calculated so that they can be used as evidence for the country's infection control policy.
BACKGROUND/OBJECTIVES: Given the increasing proportion of the Korean population that is aged 65 years and older, the present study analyzed the relationship between diet quality and sarcopenia in elderly persons by using data from the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data for 3,373 persons aged 65 years and over (men: 1,455, 43.1%) were selected from the 2008-2011 KNHANES. Sarcopenia assessments are based on a formula that divides a subject's appendicular skeletal muscle mass (ASM) by their weight (wt) and multiplies that result by 100 ([ASM/wt] × 100). Sarcopenia is present if the subject's result was less than one standard deviation (SD) below the sex-specific mean for a young reference group. For evaluation of diet quality, data obtained via the 24-hour recall method were used to calculate the Diet Quality Index for Koreans (DQI-K). A general linear model was applied in order to analyze general information and nutritional intake according to sarcopenia status. For analysis of the relationship between diet quality and sarcopenia, a binominal logistic regression analysis was undertaken. RESULTS: The sarcopenia prevalence rate among the study subjects aged 65 years and over was 37.6%. The DQI-K of those without sarcopenia was 3.33 ± 0.04 points, while that of those with sarcopenia was 3.45 ± 0.04 points (P < 0.05). The relationship between diet quality and sarcopenia revealed that subjects aged 75 and older had a poor diet quality, and their odds ratio (OR) of sarcopenia presence was significantly higher (OR: 1.807, 95% confidence interval: 1.003-3.254, P < 0.05). CONCLUSIONS: This study revealed that poor diet quality was related to sarcopenia presence in Koreans aged 75 and older. In order to improve the diet quality of the elderly (aged 75 and older), it is necessary to develop dietary improvement guidelines.
Background: Sleep disorder is a precursor to depression, which is one of the psychological factors associated with periodontal disease that, in turn, affects general and periodontal health. This study aimed to investigate the relationship between sleep duration, depression, and periodontitis in older people aged over 65 years. Methods: A total of 2,002 older adults aged 65 years or older were included in the study. Their general and health aspects, including smoking, drinking, diabetes, hypertension, and depression, were investigated. Periodontitis was examined using the Community Periodontal Index (CPI). Data were analyzed through a complex sampling design method. Frequency and crossover analyses were conducted to investigate the relationship between depression and periodontitis. To investigate the effect of depression on periodontitis, a logistic regression analysis was performed. Results: Regarding depression and participants' general characteristics, statistically significant differences were found in sex, economic activity, smoking habit, and CPI (p<0.05). In the presence of depression, the odds ratio for periodontitis was 1.84, and the adjusted odds ratio for age, sex, economic activity, residence type, household income, education level, smoking habit, drinking, hypertension, and diabetes was 1.72, representing a significant difference (p<0.05). Conclusion: This study examined the relationship between depression and periodontitis in older persons and confirmed a significant correlation. As the population of older adults increases, we should pay attention to their mental and oral health as well as systemic diseases. Various programs for the health promotion of older persons need to be implemented to improve the quality of life of older people.
This study was aimed to determine influenza vaccination coverage in 2004 in Koreans and investigate the factors associated with vaccination. Documentation of vaccination status and baseline data was conducted by a survey using questionnaire sheets. Baseline data and vaccination status were documented on 1465 people out of whom 60.1% received the influenza vaccine. Forty-seven percent of the responders were male; 4% were aged 1-12, 32% were aged 13-39, 32% were aged 40-64 and 32% were aged 65 or older. Twenty-three percent reported a chronic illness, increasing their risk for complications from influenza. Predictors of influenza vaccination were: older age (OR=11.7, 95% CI 5.1-26.8), the presence of chronic illness (OR=2.3, 95% CI 1.1-4.7), previous vaccination (OR=1.8, 95% CI 1.1-2.8), belief that influenza vaccine is effective in preventing influenza (OR=2.5, 95% CI 1.1-5.7) and education level (OR=1.7, 95% CI 1.0-2.7). Immunization rates were much higher in those who will take immunization again (OR=10.4, 95% CI 5.5-19.6). Factors affecting the decision on immunization were self-determination (43.6%), public relations (24.1%), recommendation from family members or friends (22.4%) and consulting with health professionals (5.8%). The main reason not to take influenza vaccine was the thought that they are healthy (50.1%). Overall, influenza vaccine coverage was high in those aged 65 or older. Immunization against influenza was influenced more by existing medical problem and belief about the vaccine's effectiveness, rather than sex or residence.
The purpose of this study was to investigate the relationship between age, physical activity (walking, strength exercise), subjective body shape recognition, and weight change with subjective health status in the population aged 30 years or older among the data of the National Health and Nutrition Examination Survey (2018) of Koreans. The subject and method of this study was a secondary analysis study using the 7th 3rd year National Health and Nutrition Examination Survey (2018). Age, walking days per week, strength training days per week, subjective health status, subjective body shape recognition, and weight change during the year were used the SPSS (p<.01). The response rate of walking for 7 days (every day) was 21.9% for those aged 30-45, 27.2% for those aged 50-64, and 26.6% for those aged 65 or older. aged 8.4% and over 65 years old 7.9% (p<.001). The subjective health status was positively correlated with age (.091), number of walking days per week (.739), number of days of strength exercise per week (.530), subjective perception of body shape (.256), and weight change over one year (.303). There was a relationship (p<.01). In this study, the age group that answered 'bad' in subjective health status was the highest at 21.4% of those aged 65 or older, followed by 15.7% of those aged 50-64 and 11.0% of those aged 30-45. This could be expected to improve subjective health status by walking and strength training. Based on these results, it was intended to provide basic data for preparing health-related programs to improve subjective health status of individuals according to age.
Purpose: This study was performed to examine associations of intakes of milk and dairy products, pulses, and soy foods with bone health in Koreans aged 50 yr and older. Methods: A total of 3,201 men and 3,581 women aged 50 yr and older who participated in the 2008~2011 Korea National Health and Nutrition Examination Survey were grouped by sex and age groups of 50~64 yr and 65 yr and older. Subjects within each sex and age group were divided into three bone health groups: normal, osteopenia, and osteoporosis groups based on bone mineral density. Intakes of nutrients and foods derived from 24-hour recall data were compared among three bone health groups. Associations between intake frequencies of foods, including milk, yogurt, tofu, or soy milk, and osteoporosis risk were evaluated based on confounding risk factor-adjusted logistic regression. Results: Calcium intake was in the order of normal, osteopenia, and osteoporosis in men (p < 0.01) and women (p < 0.05) aged 50~64 yr as well as in men aged 65 yr and older (p < 0.001). In women aged 50~64 yr, intake of milk and dairy products was lower in the osteoporosis group (p < 0.01) as compared with the osteopenia group. Intake of pulses or tofu was not significantly different among bone health groups. Odds ratio (OR) for milk intake frequency (${\geq}2$ times/week) compared to intake frequency less than 1 time/month was 0.45 (95% CI 0.24~0.85, p for trend = 0.022) in men aged 65 yr and older. The OR for yogurt intake frequency (1 time/month~1 time/week) was 0.47 (95% CI 0.30~0.73, p for trend = 0.019) in women aged 50~64 yr. Intake frequency of tofu or soy milk was not associated with reduced risk of osteoporosis in all groups. Conclusion: Dairy food intake was significantly associated with bone health, and its effect was sex- and age group-specific, whereas soy food intake was not. Dietary intervention to prevent osteoporosis would be effective for women aged 50~64 yr old and for men aged 65 yr and older.
The purpose of this study was to compare the usefulness of the lipid ratio indicators for the diagnosis of metabolic syndrome in the elderly aged 65 years or older. From January 2018 to December 2020, 1,464 people aged 65 years or older who underwent a health checkup at a general hospital in Seoul were included. Lipid ratio indicators were measured through blood tests. The prevalence of metabolic syndrome according to the quartiles of the lipid ratio index was confirmed by logistic regression analysis. In addition, the metabolic syndrome predictive ability and cutoff value of the lipid ratio indices were estimated with the receiver operating characteristic(ROC) curve. The correlation between atherogenic index of plasma(AIP) and waist circumference was the highest in both men and women(r=0.278, p<0.001 vs r=0.252, p<0.001). As for the lipid ratio indices, the incidence of metabolic syndrome was higher in the fourth quartile than in the first quartile. The area under the ROC curve(AUC) value of AIP was higher at 0.826(95% CI=0.799-0.850) and 0.852(95% CI=0.820-0.881) for men and women, respectively, compared to other lipid ratio indicators, and the optimal cutoff values for both men and women was 0.44(p<0.001). Therefore, the AIP among the lipid ratio indicators was found to be the most useful index for diagnosing metabolic syndrome in the elderly aged 65 years or older.
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