• Title/Summary/Keyword: Older persons

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Prevalence and Management of Dyslipidemia Among Korean Adults: KNHANES 2010-2012 (한국 성인의 이상지질혈증 유병률과 관리: 국민건강영양조사 2010-2012)

  • Jang, Sungok;Lee, Jongseok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7978-7989
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    • 2015
  • Dyslipidemia is a major risk factor for cardio-cerebrovascular disease. Although the prevalence among Korean adults is very high, its management is known to be poor. The aim of this study was to access the prevalence, awareness, treatment, and control rates of dyslipidemia according to treatment guideline rather than diagnostic criteria. The risk factors for cardio-cerebrovascular disease were evaluated to apply the appropriate risk-based threshold of the lipid treatment targets according to risk category. Analysis was done using nationally representative data (n = 16,263) collected from adults aged 20 years and older participating the Korea National Health and Nutrition Examination Survey (KNHANS) 2010-2012. The age-standardized prevalence rate of dyslipidemia according to treatment criteria was 34.1%. Of these prevalent cases, however, only 19.2% were aware; 9.5% treated; and 8.7% controlled. The age-standardized control rate among treated persons was 47.5%. Men had a significantly higher prevalence than women (39.7% vs. 28.8%), but a significantly lower rate of awareness, treatment, and control (16.0% vs. 22.3%, 7.7% vs. 11.3%, and 6.1% vs. 11.2%, respectively). As the higher risk category, the prevalence rate was higher but the control rate was lower. The prevalence of patients with diabetes was 82.5% when applying the treatment criteria (LDL-cholesterol level of ${\geq}100mg/dL$ and triglyceride level of ${\geq}200mg/dL$). However, only 11.9 % of these were controlled, whose LDL-cholesterol and triglycerides were lower than the treatment goals. Our findings suggest that effective strategies are required to decrease the gap between the prevalence of dyslipidemia and the following treatment. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the National Health Screening Program, especially in the high risk group of cardio-cerebrovascular disease.

The Association of Central Obesity with Type 2 Diabetes among Koreans according to the Serum Gamma-Glutamyltransferase Level: Korean Genome and Epidemiology Study (혈청 Gamma-Glutamyltransferase에 따른 복부비만과 제2형 당뇨병간의 관련성: Korean Genome and Epidemiology Study)

  • Shin, Ji-Yeon;Hwang, Jun-Hyun;Jeong, Jin-Young;Kim, Sung-Hi;Moon, Jai-Dong;Roh, Sang-Chul;Kim, Young-Wook;Kim, Yang-Ho;Leem, Jong-Han;Ju, Young-Su;Hong, Young-Seoub;Ha, Eun-Hee;Lee, Yong-Hwan;Lee, Duk-Hee;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.386-391
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    • 2009
  • Objectives : This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. Methods : The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. Results : The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT ($p_{trend}$<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. Conclusions : Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was highnormal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.

Life in Old Age and Images of the Aged Perceived by Middle-Aged and Old-Aged Generations in Capital Region in Korea (수도권 지역 중년기 이후 세대의 노후생활 인식과 노인에 대한 인식)

  • Choi, Sung-Jae
    • 한국노년학
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    • v.29 no.1
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    • pp.329-352
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    • 2009
  • This study examined life in old age and images of the aged perceived by middle-aged and old-aged generations through indepth interviews with 30 persons aged 40s through 80s residing in three areas (city or county) in capital region in Korea to use it as basic information in planning social welfare policy and reorganizing social services in response to population aging in capital region in Korea. In terms of economic life of the middle-aged and olde-aged generations perceived older people's opportunities for work were rarely given to the aged due to ageism and negative stereotypes of aging and the aged, and the aged tended to regard themselves less able or unable to work. In terms of social life of the aged both middle-aged and old-aged generations perceived that the frequency of social participation was low, and the daily life of the aged was found mostly aimless, unorganized and unplanned. In terms of psycho-social life of the aged both generations still felt that they were not alienated from the family, neighbors, and the society. In terms of social welfare services both generations thought the aged needed basic services such as income maintenance, health care, housing services, and particularly they felt lack of social services. The old-aged generation was willing to travel to the distance taking more than one hour to receive social services that they would need. Both the middle-aged and the old-aged agreed upon the necessity of preparation for old age and the benefits of earlier preparation, however, they said that they could not prepare for their old age due to lack of social programs to help preparation for old age and due to spending for rearing and education of their children. In terms of perceived life in old age both middle-aged and old-aged generations tended to be slightly positive, but the degree of positiveness differed between respondents from urban area and those from rural area regardless of generations. Images of the aged were perceived to be overwhelmingly negative while positive images were very few in number regardless of generations. This finding may suggests that negative stereotypes on aging and the aged are also prevalent in Korean society like in Western societies. Based on findings of this study some implications for social policies in response to population aging in capital region were suggested.

Evaluation of the Neural Fiber Tractography Associated with Aging in the Normal Corpus Callosum Using the Diffusion Tensor Imaging (DTI) (확산텐서영상(Diffusion Tensor Imaging)을 이용한 정상 뇌량에서의 연령대별 신경섬유로의 변화)

  • Im, In-Chul;Goo, Eun-Hoe;Lee, Jae-Seung
    • Journal of the Korean Society of Radiology
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    • v.5 no.4
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    • pp.189-194
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    • 2011
  • This study used magnetic resonance diffusion tensor imaging (DTI) to quantitatively analyze the neural fiber tractography according to the age of normal corpus callosum and to evaluate of usefulness. The research was intended for the applicants of 60 persons that was in a good state of health with not brain or other disease. The test parameters were TR: 6650 ms, TE: 66 ms, FA: $90^{\circ}$, NEX: 2, thickness: 2 mm, no gap, FOV: 220 mm, b-value: $800s/mm^2$, sense factor: 2, acquisition matrix size: $2{\times}2{\times}2mm^3$, and the test time was 3 minutes 46 seconds. The evaluation method was constructed the color-cored FA map include to the skull vertex from the skull base in scan range. We set up the five ROI of corpus callosum of genu, anterior-mid body, posterior-mid body, isthmus, and splenium, tracking, respectively, and to quantitatively measured the length of neural fiber. As a result, the length of neural fiber, for the corpus callosum of genu was 20's: $61.8{\pm}6.8$, 30's: $63.9{\pm}3.8$, 40's: $65.5{\pm}6.4$, 50's: $57.8{\pm}6.0$, 60's: $58.9{\pm}4.5$, more than 70's: $54.1{\pm}8.1mm$, for the anterior-mid body was 20's: $54.8{\pm}8.8$, 30's: $58.5{\pm}7.9$, 40's: $54.8{\pm}7.8$, 50's: $56.1{\pm}10.2$, 60's: $48.5{\pm}6.2$, more than 70's: $48.6{\pm}8.3mm$, for the posterior-mid body was 20's: $72.7{\pm}9.1$, 30's: $61.6{\pm}9.1$, 40's: $60.9{\pm}10.5$, 50's: $61.4{\pm}11.7$, 60's: $54.9{\pm}10.0$, more than 70's: $53.1{\pm}10.5mm$, for the isthmus was 20's: $71.5{\pm}17.4$, 30's: $74.1{\pm}14.9$, 40's: $73.6{\pm}14.2$, 50's: $66.3{\pm}12.9$, 60's: $56.5{\pm}11.2$, more than 70's: $56.8{\pm}11.3mm$, and for the splenium was 20's: $82.6{\pm}6.8$, 30's: $86.9{\pm}6.4$, 40's: $83.1{\pm}7.1$, 50's: $81.5{\pm}7.4$, 60's: $78.6{\pm}6.0$, more than 70's: $80.55{\pm}8.6mm$. The length of neural fiber for normal corpus callosum were statistically significant in the genu(P=0.001), posterior-mid body(P=0.009), and istumus(P=0.012) of corpus callosum. In order of age, the length of neural fiber increased from 30s to 40s, as one grows older tended to decrease. For this reason, the nerve cells of brain could be confirmed through the neural fiber tractography to progress actively in middle age.

Relationship between Physical Health Status and Life style(Health Practices) (건강상태(健康狀態)와 생활양식(生活樣式)(건강습관(健康習慣))과의 관계(關係))

  • Choi, In-Sook;Roh, Pyong-Ui;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.3
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    • pp.111-140
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    • 2002
  • This study was conducted from April 1 through April 30, 2002 in order to figure out the relationship between physical health status and life style and the factors influencing physical health. Subjects were selected from among the residents older than 20 years old by probability scheme of one out of 2000. Three thousand people were interviewed by questionnaires, and 2,742(91.4%) respondents were used for analysis, and the results are as follows: 1. Ridit(Relatives to an identified distribution it) of category one by sex was 0.26 in man, and 0.25 in woman. Ridit of category two was 0.57 in man and 0.53 in woman, those of category three was 0.72 in man and 0.65 in woman. That of category four was 0.86 in man and 0.85 in woman, that of category five was 0.95 in man and 0.97 in woman, and that of category six was 0.98 in man and 0.99 in woman. The ridits and health related categories by sex were r=.954 in man and r=.966 in woman(p<0.01) 2. Ridits of healthy behavior 2-1. The ridit of males who slept for less than 6 hrs was 0.71, that of those who slept for $7{\sim}8$ hrs was 0.24, and that of those who slept for more than 9 hours was 0.96. The ridit of females who slept for less than 6 was 0.80, that of those who slept for $7{\sim}8$ hrs was 0.32, and that of those who slept for more than 9 hrs was 0.97. 2-2. The ridit of male, who ate breakfast everyday was 0.30, that of those who ate one to four breakfast per week was 0.87, and that of those who never ate breakfasts was 0.96. The ridit of females who ate breakfast everyday was 0.32, that of those who ate breakfast one to four times a week was 0.75, and that of those who never ate breakfast was 0.99. 2-3. The ridit of males whose body weights were 10% lower than normal body weight was 0.45, that of those with $5{\sim}9.9%$ less than normal body weight was 0.28, that of those with ${\pm}4.9%$ of normal body weight was 0.12, that of those whose body weights were $5{\sim}9.9%$ heavier than normal was 0.40, that of those whose body weights were $10{\sim}19.9%$ heavier than normal was 0.74, that of those with $20{\sim}29.9%$ heavier than normal body weights was 0.78 and that of those with 30% heavier than normal body weight was 0.87. That of females with 10% less than normal body weight was 0.53, that of those with $5{\sim}99%$ less than normal body weight was 0.32, that of 4.9% those with ${\pm}f$ normal body weight was 0.14, that of those with 5.0 to 9.9% heavier body weights was 0.43, that of those with 10 to 19.9% heavier body weight was 0.65, that of those with $20{\sim}29.9%$ heavier body weight was 0.94 and that of those with more than 30% of normal body weight was 0.94. 2-4. The ridit of males who exercised everyday was 0.11, that of those who exercised three to four times a week was 0.25, that of those exercising once or twice a week was 0.48, and that of those who never exercised was 0.80. The ridit of females exercising everyday was 0.08, that of those exercising three to four times a week was 0.21, that of those exercising one to two times was 0.35 and that of those who never exercised was 0.72. 2-5. The ridit of males who did not drink at all was 0.14, that of those who drank one or two cups of hard liquor(Soju) was 0.39, that of those who drank a half bottle of Soju was 0.56, that of those who darnk a bottle of Soju was 0.73 and that of those who drank two bottles of Soju was 0.96. The ridit of females who did not drink at all was 0.30, that of those who drank one or two cups of Soju was 0.70, that of those who drank a half bottle of Soju was 0.84, that of those who drank a bottle of Soju was 0.97 and that of those who drank more than two bottles of Soju was 0.99. 2-6 The ridit of males who did not smoke was 0.20, that of those who smoked one or two cigarettes was 0.44, that of those who smoked about ten cigarettes was 0.58, and that of those who smoked more than a pack of cigarettes was 0.85. The ridit of females who did not smoke at all was 0.90, that of those who smokes one or two cigarettes was 0.91, that of those who smoked about the cigarettes was 0.93 and that of those who smoked more than a pack of cigarettes was 0.96 3. The ridit of males who had healthy behavior in six categories was 0.43 and the average age of them was 45, that of those who had healthy behavior in five categories was 0.47 and the average age was 45, that of those who had healthy behavior in three categories was 0.50 and the average age was 43, that of those who had heathy behavior in two categories was 0.60 and the average age was 40, that of those who had healthy behavior in one category was 0.68 and the average age was 38, and that of those who did not have healthy behavior at all in six categories was 0.79 and the average age was 41. The ridit of females who had heathy behavior in six categories was 0.38 and the average age was 45, that of those who had healthy behavior in five categories was 0.40 and the average age was 44, that of those who had healthy behavior in four categories was 0.46 and the average age was 43, that of those who had healthy behavior in three categories was 0.52 and the average age was 44, that of those who had healthy behavior in two categories was 0.57 and the average age was 41, that of those who the healthy behavior in one category was 0.62 and the average age was 40, and that those who did not have healthy behavior in six categories was 0.79 and the average age was 43. 4. The health statues of the persons who the healthy behavior were better than those who did not have healthy behavior. If the people have healthy behavior in young age and they have healthy education continuously, they can live healthier lives.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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