• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.63-72
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• 2021

Objectives: Recent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults. Methods: This study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry. Results: In total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS. Conclusions: Depression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.

• Health Policy and Management
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• v.32 no.3
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

• Journal of People, Plants, and Environment
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• v.23 no.1
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• pp.35-46
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• 2020

The purpose of this study was to investigate the effects of the horticultural therapy program on patients with mild cognitive impairment and mild dementia depending on the frequency and duration of the interventions. We developed the same 15-session program to improve cognitive functions and life satisfaction and alleviate depression of the elderly women with mild cognitive impairment or mild dementia. Subjects in Longer Treatment group participated in the program once a week for 15 weeks and subjects in Shorter Tratmet group participated twice a week for 7½ weeks. This study conducted pretest-posttest verification of both groups using quasi-experimental design involving 21 subjects. Elderly life satisfaction, Geriatric Depression Scale (short form), and the Korean Version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) were used in the evaluation. As a result, both groups showed an increase in life satisfaction, and a decrease in depression. However, there was a significant difference in the changes of the CERAD-K scores between the two groups (p < .05). In Longer Treatment group, life satisfaction increased significantly (p < .001), and depression decreased at a marginally significant level (p = .068), but no statistically significant change was observed in neurocognitive function. In Shorter Treatment group, life satisfaction increased at a marginally significant level (p = .059), and depression and CERAD-K scores decreased significantly (p < .05). However, in the case of Mini-Mental State Examination (MMSE-K), there was no significant change in both groups. According to these results, when planning a horticultural therapy program for persons with mild cognitive impairment or mild dementia, it is effective to organize and execute the program by determining the duration of intervention as 3 to 4 months or longer, even if this reduces the number of interventions per week.

• Journal of People, Plants, and Environment
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• v.22 no.6
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• pp.699-709
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• 2019

Various health and social issues related to the elderly are emerging in line with the rapid aging of the population. In particular, dementia currently has a prevalence of about 10 percent of the elderly population in South Korea, which increases financial and social burdens to not only individual patients but also their caring family. To assess the effects of participating in the forest therapy programs for dementia prevention, this study recruited participants aged 50 and above and tested their depression (Korean form of Geriatric Depression Scale; KGDS) and stress response (Modified form of Stress Response Inventory; SRI-MF), which are emotional aspects of dementia. As a result, KGDS showed a significant decrease of 3.2 points from 8.4 to 5.2 points, and SRI-MF showed a significant decrease of 7.2 points from 40 to 32.8 points, indicating a statistically significant improvement in both. In addition, participants with minor depression and high level of stress in the pretest showed statistically significant improvements in the SRI-MF for men, and the KGDS and SRI-MF for women. Furthermore, there were statistically significant improvements in KGDS for participants in their 60s and in SRI-MF for those in their 70s in terms of age, and in both KGDS and SRI-MF for participants with chronic diseases and in KGDS for participants without chronic diseases. This study confirmed the effects of forest therapy on the prevention of the emotional aspects of dementia and laid the groundwork for increasing the applicability of forest therapy by obtaining a place for dementia prevention as a field of forest therapy.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.378-388
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• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.123-135
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• 2005

Objectives:EEG coherence could imply the connectivity between two different areas of the brain, which is known to be important in the pathophysiology of bipolar I disorder(BPD I) and schizophrenia. The authors investigated EEG coherence in patients with BPD I and schizophrenia to examine the connectivity of the neural circuit. Methods:EEGs were recorded in 15 schizophrenia and 14 bipolar disorder patients, and 14 age-matched normal control subjects from 16 electrodes with linked-ear reference. Spectral parameters and coherence were calculated for the alpha bandwidth(8-13Hz) by a multi-channel autoregressive model using 20 artifact-free 2-seconds epochs and the differences were compared among three groups by two different statistical methods;F-test and Kruskal-Wallis test. Furthermore, when there were significant differences among three groups, Scheffe's multiple comparison tests were provided and Jonckheere-Terpstra tests for the ordered alternative were given. Results:In the intra-hemispheric comparison, left frontal coherence was increased in order of control, BPD I and schizophrenia. In the inter-hemispheric comparison, 1) inter-prefrontal coherence in BPD I was signifi- cantly higher than in normal controls, and 2) inter-prefrontal coherence in schizophrenia was significantly lower than in controls. Conclusion:These results suggest that 1) both schizophrenia and BPD I are diseases having the abnormality of neural circuit connectivity in both frontal and prefrontal lobes, and 2) the abnormality is more severe in schizophrenia than in BPD I. Furthermore, the data support that a common pathogenetic process may reside in both schizophrenia and BPD I.

• Korean Journal of Biological Psychiatry
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• v.20 no.2
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• pp.45-53
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• 2013

Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.294-303
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• 2017

As the elderly population increases, the prevalence of various geriatric chronic diseases and dementia diseases is also rapidly increasing; accordingly, dementia is becoming a major concern of our society. In this study, 48 elderly patients with mild cognitive impairment located in K district were selected from a group of experimental groups in one building and a control group in one building and evaluated for blood homocysteine levels and cognitive function changes after 4,8, and 12 weeks of taking vitamin supplements. The Chi-squared test, Fisher's Exact test, independent t-test, repeated measures ANOVA, contrast test, repeated measures ANCOVA, and Wilks' lambda test were utilized to analyze the data. The results revealed that the cognitive function of the experimental group was significantly higher than that of the control group at 12 weeks (p<0.05), and so, the experimental group higher than that of the control group (p<0.01), the effect of taking vitamins was significantly increased, indicating that homocysteine was decreased relative to the control group. Therefore, vitamin supplements may prevent decreases in cognitive functions and dementia among elderly patients with mild cognitive impairment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.260-269
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• 2018

This study investigated the needs of the elderly with dementia from the perspectives of patients and caregivers in long-term care facilities. A total of 145 older adults with dementia and 62 nurses from 3 geriatric hospitals were enrolled in this study. The cognitive function, behavioral and psychological symptoms, activities of daily living (ADL), and instrumental activities of daily living (IADL) were measured. The mean number of needs reported by the elderly with dementia was 11.94 and those with unmet needs were 2.91 on average. Nurses showed that the mean number of needs and unmet needs of the elderly with dementia was 14.71 and 1.94, respectively. The largest number of older adults with dementia (42.2%) perceived that the needs for daytime activities were unmet. On the other hand, only 24.1% of nurses evaluated that the needs for daytime activities were unmet. The factors influencing the needs of the elderly with dementia were dependency in ADL and IADL. Therefore, caregivers in long-term care facilities need to take the perception of older adults with dementia into consideration when evaluating the met and unmet needs of the elderly with dementia. In addition, sufficient assistance to IADL and ADL would help reduce the needs of people with dementia.

• Journal of Music and Human Behavior
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• v.12 no.1
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• pp.43-64
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• 2015

This study investigated the effects of song discussion on depression and rehabilitation motivation in stroke patients. Older adults with chronic stroke participated in this study: nine for the experimental group and eight for the control group. The experimental group was divided into three subgroups and participated in 12 sessions over 6 weeks. Target lyrics were selected by the investigator among popular songs from the participants' young adulthood. The song-based discussion was facilitated to address issues targeted at supportive, insight-focused, or reconstructive stage. The control group was provided with delayed intervention. At pre and posttest, the short form of Geriatric Depression Scale and the Rehabilitation Motivation Scale were measured. The experimental group showed significantly decreased depression and significantly increased rehabilitation motivation (p < .01), while the control group showed no significant changes. Positive changes were also observed in all subcategories of rehabilitation motivation in the experimental group, particularly in significantly increased task-oriented motivation and decreased amotivation. This study suggests that song discussion will be effectively applied in rehabilitative settings to address psychological issues of older adults with stroke.