• The Korean Journal of Health Service Management
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• v.5 no.3
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• pp.123-132
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• 2011

To evaluate the impact of avoidable mortality on the changes in life expectancy at birth in Korea. Standard life table techniques and the Arriaga method were used to calculate and to decompose life expectancy changes by age, effects and groups of causes of avoidable mortality among two periods(1990-2000 and 2000-2009). A list of causes of avoidable mortality reached by consensus and previously published in Spain was used. Mortality in young adults produced a reduction in life expectancy at birth during the 1990-2000, but there was an important increase in life expectancy at birth during the 2000-2009; in both cases, this was the result of factors amenable to health policy interventions. The highest improvement in life expectancy at birth was due to non-avoidable causes, but avoidable mortality through health service interventions showed improvements in life expectancy at birth in those elderly people than 1 year and in those younger. Making a distinction between several groups of causes of avoidable mortality and using decomposition by causes, ages and effects allowed us to better explain the impact of avoidable mortality on the life expectancy at birth of the whole population and gave a new dimension to this indicator that could be very useful in public health.

• Journal of Korean Medicine for Obesity Research
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• v.6 no.2
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• pp.51-58
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• 2006

Objectives : Obesity causes serious medical complications and impairs quality of life in older persons. We review the literature on the clinical issues related to obesity in elderly and suggest appropriate weight-management guidelines for obese older patients. Methods : PubMed Database and RISS were searched for articles relating to obesity in the elderly. We classified articles according to clinical characteristics, assessments, medical complications, and therapy. Results and Conclusions : The current data show that obesity in elderly is associated with increased mortality, metabolic abnormalities, arthritis, pulmonary abnormalities, urinary incontinence, cancer, and impaired quality of life. Therefore, clinical studies are needed to demonstrate the effectiveness andsafety of weight-loss treatments in obese elderly.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• Journal of Korean Neurosurgical Society
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• v.47 no.6
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• pp.442-445
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• 2010

Objective : The purpose of this study was to examine the efficacy and safety of microvascular decompression (MVD) for hemifacial spasm (HFS) in elderly patients. Methods : Between 1997 and June 2008, 1,174 patients had undergone MVD for HFS at our institute. Among these, 53 patients were older than 65 years. We retrospectively reviewed and compared the complication and the cure rates of these patients with those of younger patients. Results : There were 38 females and 15 males. The mean duration of symptoms of HFS of these patients was 94.6 months (range, 12-360 months), compared with 67.2 months (range, 3-360 months) in the younger group. The overall cure rate in elderly patients who underwent MVD for HFS during this period was 96.2%. Permanent cranial nerve dysfunctions, such as hearing loss and facial palsy, were seen in 2 patients (3.8%, 2/53) in the elderly group and 19 patients (1.7%, 19/1121) in the younger group. The difference in permanent cranial nerve dysfunction between the two groups was not statistically significant. There was no operative mortality in either group. Conclusion : Microvascular decompression is the most effective surgical modality available for the treatment of HFS. Results of this study indicate that such technique can be performed in the elderly without higher rates of morbidity or mortality. Any patient with HFS, whose general health is acceptable for undergoing general anesthesia, should be considered as a candidate for MVD.

• Journal of Preventive Medicine and Public Health
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• v.38 no.3
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• pp.283-290
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• 2005

Objectives : The aim of this paper was to examine the relationship between the summertime (June to August) heat index, which quantifies the bioclimatic apparent temperature in sultry weather, and the daily disease-related mortality in Seoul for the period from 1991 to 2000. Methods : The daily maximum (or minimum) summertime heat indices, which show synergetic apparent temperatures, were calculated from the six hourly temperatures and real time humidity data for Seoul from 1991 to 2000. The disease-related daily mortality was extracted with respect to types of disease, age and sex, etc. and compared with the time series of the daily heat indices. Results : The summertime mortality in 1994 exceeded the normal by 626 persons. Specifically, blood circulation-related and cancer-related mortalities increased in 1994 by 29.7% (224 persons) and 15.4% (107 persons), respectively, compared with those in 1993. Elderly persons, those above 65 years, were shown to be highly susceptible to strong heat waves, whereas the other age and sex-based groups showed no significant difference in mortality. In particular, a heat wave episode on the 22nd of July 2004 ($>45^{\circ}C$ daily heat index) resulted in double the normal number of mortalities after a lag time of 3 days. Specifically, blood circulation-related mortalities, such as cerebral infraction, were predominant causes. Overall, a critical mortality threshold was reached when the heat index exceeded approximately $37^{\circ}C$, which corresponds to human body temperature. A linear regression model based on the heat indices above $37^{\circ}C$, with a 3 day lag time, accounted for 63% of the abnormally increased mortality (${\geq}+2$ standard deviations). Conclusions : This study revealed that elderly persons, those over 65 years old, are more vulnerable to mortality due to abnormal heat waves in Seoul, Korea. When the daily maximum heat index exceeds approximately $37^{\circ}C$, blood circulation-related mortality significantly increases. A linear regression model, with respect to lag-time, showed that the heat index based on a human model is a more dependable indicator for the prediction of hot weather-related mortality than the ambient air temperature.

• The Journal of Asian Finance, Economics and Business
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• v.1 no.4
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• pp.5-13
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• 2014

This study contributes to addressing the problem of an aging population by providing important information that determines feasible monthly payments for the clients of Chinese reverse mortgage products and by promoting the implementation of reverse mortgages in China. The variables used in this study include mean values obtained from time series data, of the rate of increase of housing prices, and the probability value, interest rate, and mortality rate obtained through the geometric Brownian motion (GBM). For mortality rates, China Life Insurance female mortality rates (2000-2003) were used. This study aims to apply the main variables that affect reverse mortgage products in a monthly payment model based on Chinese financial market conditions, and determine loan values. In this study, Shanghai's reverse mortgage monthly payments, by age levels, were calculated through the loan-to-value (LTV) and payment (PMT) methods to evaluate the value of the reverse mortgages. Based on the optimal combination of the three factors of payment amount, loan interest rates, and the level of acceptance of prices, efforts must be made to extract the best value for the elderly. Only in this way can the interests of both lenders and borrowers be protected, by increasing the market share and economies of scale of the reverse mortgage industry and effectively improving the living standards of the elderly.

• Journal of Environmental Health Sciences
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• v.35 no.4
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• pp.249-258
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• 2009

The objectives of this study were to compare the relative risk of all-cause mortality and cause-specific mortality associated with Asian dust events, and especially to investigate the effects on the susceptible population such as the elderly and children, which were based on the data in Seoul from 2000 to 2006. Both of the study periods with/without Asian dust days, respiratory-cause mortality was the highest, followed by cardiovascular-cause mortality and all-cause mortality in sequence among mortality related to air pollution for all-aged group. As to susceptible group, the relative risk of mortality is the highest for +65 yrs group among all-cause mortality. According to comparison of mortality with/without Asian dust days, the relative risk of all-cause mortality is larger in the model with Asian dust days than the one in the model without Asian dust days among all age group (except for under 15 yrs group) and all air pollutants. The relative risk of cause-specific mortality (except for ozone in under 15 yrs group in case of respiratory-cause mortality, and ozone in all age group and over 65 yrs group in case of cardiovascular-cause mortality) per IQR increase of each pollutant is larger in the model without Asian dust days.

• Sleep Medicine and Psychophysiology
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• v.14 no.1
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• pp.13-19
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• 2007

Sleep disordered breathing is highly prevalent in the elderly and affects older men and women similarly. Nocturia, cardiovascular diseases, cognitive impairment, traffic accidents and repeated falls are common manifestations of sleep apnea in the elderly and sleep study may be indicated in these patients. When a sleep study is planned, reliable markers of respiratory efforts and a tibial EMG should be included because central sleep apneas and periodic leg movements are common in the elderly patients. Although cardiovascular morbidity and mortality seem to be lower in the elderly than in middle-aged adults, these may not be as low as commonly believed. Excessive daytime sleepiness, cognitive dysfunction and nocturia can be improved by effective treatment with continuous positive airway pressure and a therapeutic trial should be recommended to all symptomatic patients. It is still unclear whether sleep apnea in older adults is a specific entity or the same disease as in younger adults. Further clinical research is warranted.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.157-162
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• 2015

The descriptive epidemiological study aimed to analyse the mortality trends from gynaecological cancer in Serbia. Average annual percentage of change (AAPC) and the corresponding 95% confidence intervals (CIs) were computed for trend using joinpoint regression analysis. Nearly 25,000 gynaecological cancer deaths occurred in Serbia during the 1991-2010 period, with the average annual age-standardised mortality rate being 17.2 per 100,000 women. Increase of mortality was observed for cancer of the vulva and vagina (AAPC=+1.3%, 95% CI=0.1 to 2.6), ovarian cancer (AAPC=+0.8%, 95% CI=0.4-1.3) and for cervical cancer (AAPC=+0.7%, 95% CI=0.3 to 1.1). Mortality rates for gynaecological cancer overall declined in women aged 30-39 years, but mortality was increased in middle-aged women (for cervical cancer) and in the elderly (for ovarian cancer). Improvements to and implementation of the national cervical cancer screening programme conducted in 2013 and expected to be finalised in the following years throughout Serbia should contribute to improvement.

• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.199-207
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• 2021

Objectives: Physical inactivity is the fourth leading global risk factor for mortality, followed by obesity. The combination of these risk factors is associated with non-communicable diseases, impaired physical function, and declining mental function. The World Health Organization recommends physical activity to reduce the mortality rate. Thus, this study examined the effects on anthropometric measurements of a 12-week walking program for elderly people in Samarahan, Sarawak, Malaysia with a 7000-step goal and weekly group walking activities. Methods: A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m². BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted. Results: In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m²), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%). Conclusions: A 12-week walking program combining a 7000-step goals with weekly group walking activities had a significant effect on the anthropometric measurements of previously inactive and overweight/obese elderly people.