• The Journal of the Korea Contents Association
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• v.19 no.4
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• pp.129-137
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• 2019

The aim of this study was to investigate the association between self-rated oral health, self-rated health, and quality of life (QOL) among older population from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII-1, 2016). Data of 1,866 older adults (Mean age 69.5 years) were analyzed with hierarchical logistic regression analyses with IBM SPSS 23.0. Over 87.7% of the subjects rated their oral health as fair or poor. Women and less educated participants more likely to report their perceived oral health as poor (p<.05). Older participants who rated their general health positively were more likely to rate their oral health as good (F=19.04, p<.001). Elders who had bad perceived health (OR: 2.86, 95% CI: 1.5~5.5), had carries in permanent teeth (OR: 2.68, 95% CI: 1.67~4.32) and anxiety or depression (OR: 1.45, 95% CI: 1.42~2.57) had negative oral health perception after controlling for covariates. In conclusion, perceived oral health and QOL were associated with each other in Korean older adults. Therefore, it is recommended to approach holistic strategy for improve health and quality of life in the elderly population.

• Hip & pelvis
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• v.30 no.4
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• pp.269-275
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• 2018

Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson's scoring system. Results: More patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be $-2.506{\pm}0.22$ (mean${\pm}$standard deviation); all patients were within the range of -2.0 to -2.8. The duration of radiological union was $13.67{\pm}1.77$ weeks. Salvati and Wilson's scoring at 12 months of follow up was $30.96{\pm}4.97$. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out. Conclusion: Bone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.

• The Journal of the Convergence on Culture Technology
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• v.4 no.4
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• pp.201-206
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• 2018

The fourth fiscal estimate of the national pension following the aging of the population and falling yields estimated that the fund ran out in 2057, three years earlier than the third fiscal calculation. Accordingly, the government proposed a plan to immediately raise the insurance premium rate by 2 percent and maintain the income replacement rate by 45 percent, and to reduce the income replacement rate by 40 percent in 2028. In this form, increasing premiums and reducing income replacement rates will allow younger generations to sign up differently from existing subscribers, who previously had higher income replacement rates at lower rates. Therefore, the study aims to ease the burden on the elderly and younger by applying different insurance rates and income replacement rates for different ages.

• Korea Journal of Hospital Management
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• v.24 no.3
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• pp.1-10
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• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.26 no.3
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• pp.197-209
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• 2019

Purpose: This study was done to examine good death awareness, attitudes toward advance directives (ADs), and preference for care near the end-of-life (PCEOL) of hospitalized elders in long-term care hospitals. Relevant characteristics were investigated as well as correlation of the variables. Methods: This descriptive research study involved 161 hospitalized elderly patients in long-term care hospitals. A self-report questionnaire was used to measure Good Death Scale, ADs Survey, PCEOL Scale, and general characteristics. Collected data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation with SPSS/WIN 23.0. Results: In terms of good death awareness, a significant difference was observed; in according to age (F=3.35, p=.037), payer of treatment costs (F=3.98, p=.021), mobility (F=3.97, p=.021), heard discussion about ADs (t=-3.89, p<.001), and willing to complete ADs (t=2.12, p=.036). As far as attitudes toward ADs, the participants presented significant difference depending on religion (t=2.38, p=.018), average monthly income (F=3.91, p=.022), duration of hospital admission (F=5.33, p=.006), person to discuss ADs (t=-2.76, p=.006). On PCEOL, there was a significant difference, depending on religion (t=-3.59, p<.001) and perceived health status (F=3.93, p=.022). Finally, as for how the variables were related to each other, good death awareness and attitudes toward ADs had a weak positive correlation with PCEOL. Conclusion: To help seniors staying in nursing homes face a good death and enjoy autonomy, there should be educational and support systems that reflect each individual's sociodemographic characteristics so that the seniors can choose what kind of care they want to receive near the end-of-life.

• Nutrition Research and Practice
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• v.13 no.3
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• pp.256-262
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• 2019

BACKGROUND/OBJECTIVES: The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS: The study subjects were 25 men and 23 women with a mean age of $72.2{\pm}3.9\;years$ and $70.0{\pm}3.3\;years$, and mean BMI of $24.0{\pm}2.1$ and $23.9{\pm}2.7$, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS: In men, the DRI equation had a -7.2% bias and accurately predicted the EER (meaning EER values within ${\pm}10%$ of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of -0.1% and an accuracy rate of 84%. In women, the bias was -6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS: The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.

• Journal of the Korean Society of Food Culture
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• v.34 no.1
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• pp.23-33
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• 2019

This study examined the historical changes of and dietitians' needs for the Life Cycle-based Dietary Guidelines for Koreans. Content analysis of relevant documents, a survey of 307 dietitians, and in-depth interviews with eight dietitians were conducted. The dietary guidelines published between 2003 and 2004 included one set of common guidelines and several sets of dietary action guides corresponding to six target groups: pregnant and lactating women, infants and toddlers, children, adolescents, adults, and the elderly. The guidelines were revised between 2008 and 2011 and consisted of six sets of guidelines for the target groups without common guidelines. The dietitians considered five or six as appropriate numbers of guidelines for each group. Needs for separate guidelines for women of child-bearing age and male workers were reported. The dietitians preferred one set of common guidelines with specific action guides for each target group and wanted easier and more specific messages to be included in the new guidelines. It is suggested that the Life Cycle-based Dietary Guidelines for Koreans should be revised to reflect such dietitians' needs.

• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.51-59
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• 2021

Objective : Several studies have reported inconsistent findings among countries on whether off-hour hospital presentation is associated with worse outcome in patients with acute stroke. However, its association is yet not clear and has not been thoroughly studied in Korea. We assessed nationwide administrative data to verify off-hour effect in different subtypes of acute stroke in Korea. Methods : We respectively analyzed the nationwide administrative data of National Emergency Department Information System in Korea; 7144 of ischemic stroke (IS), 2424 of intracerebral hemorrhage (ICH), and 1482 of subarachnoid hemorrhage (SAH), respectively. "Off-hour hospital presentation" was defined as weekends, holidays, and any times except 8:00 AM to 6:00 PM on weekdays. The primary outcome measure was in-hospital mortality in different subtypes of acute stroke. We adjusted for covariates to influence the primary outcome using binary logistic regression model and Cox's proportional hazard model. Results : In subjects with IS, off-hour hospital presentation was associated with unfavorable outcome (24.6% off hours vs. 20.9% working hours, p<0.001) and in-hospital mortality (5.3% off hours vs. 3.9% working hours, p=0.004), even after adjustment for compounding variables (hazard ratio [HR], 1.244; 95% confidence interval [CI], 1.106-1.400; HR, 1.402; 95% CI, 1.124-1.747, respectively). Off-hours had significantly more elderly ≥65 years (35.4% off hours vs. 32.1% working hours, p=0.029) and significantly more frequent intensive care unit admission (32.5% off hours vs. 29.9% working hours, p=0.017) than working hours. However, off-hour hospital presentation was not related to poor short-term outcome in subjects with ICH and SAH. Conclusion : This study indicates that off-hour hospital presentation may lead to poor short-term morbidity and mortality in patients with IS, but not in patients with ICH and SAH in Korea. Excessive death seems to be ascribed to old age or the higher severity of medical conditions apart from that of stroke during off hours.

• Journal of Nutrition and Health
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• v.54 no.1
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• pp.1-9
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• 2021

This review describes the risk factors of the nutrition crisis in coronavirus disease 2019 (COVID-19) infections and suggests precision nutrition against long-term psychological and physiological stress. The mandatory quarantine and the social distancing are associated with an interruption of the lifestyle routine, resulting in psychological (i.e., boredom) and physiological stress. The stress with multiple causes and forms induces over-compensation of energy-dense food, such as sugary comfort food, and is defined as "food craving" because carbohydrates positively affect the psychological stability with serotonin secretion. The consumption of foods that promote an immune response against viral infections (vitamins & minerals; Cu, folate, Fe, Se, Zn, and Vit A, B6, B12, C, and D), reduce inflammatory cytokines (w-3 fatty acids, Vit D, fibers, and Mg), contain antioxidants (beta-carotene, Vit E, C, Se, and phenolics), and sleep-inducing proteins (serotonin, melatonin, and milk products) is essential. In addition, a reduced Vit D deficiency in winter due to less time spent outdoors under quarantine has been reported to be associated with viral infections. The case fatality rate of COVID-19 was significantly dependent on age, sex, race, and underlying health condition. To prevent malnutrition and cachexia in elderly people, weight loss and muscle wasting should be monitored and controlled. Inadequate protein intake, sedentary lifestyle, and inflammation are significant risk factors for sarcopenia. Moreover, relatively high intakes of fat or carbohydrate compared to low protein intake result in abdominal obesity, which is defined as "sarcopenic obesity." Keeping the food-safety guidelines of COVID-19, this study recommends the consumption of fresh and healthy foods and avoiding sugar, fat, salt, alcohol, and commercially frozen foods.

• 한국노년학
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• v.32 no.3
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• pp.835-850
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• 2012

The recent trend shows that the number of internet users among older adults and their level of the ability to use internet have been increased. The purpose of this study is to investigate the phenomenon of senior information technology. Using qualitative descriptive method, this study aims to explore how and in which context older adults use internet. It also aims to address the nature and the outcomes of elderly people's use of internet in their daily lives. In-depth interviews with 16 older participants were analyzed with qualitative content analysis and constant comparison method. The finding shows as follows: (1) agonies felt by the "ambiguous" age group in the modern society, (2) the analogue generation joining the digital, (3) daily changes according to the internet use, (4) senior information technology and its flip side of coin. Based on the research findings, implications for senior information policy are addressed in three ways: promoting productive use of internet among older adults, meeting their health-related concerns using internet, and finding ways to integrate the idea of humanities into senior information technology.