• Journal of Korean Academic Society of Home Health Care Nursing
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• v.29 no.3
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• pp.288-300
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• 2022

Purpose: This study aimed to investigate the association of social participation and depressive symptoms with health-related quality of life (HRQoL) among older adults living in urban and rural areas. Methods: This secondary, cross-sectional study was conducted with a total of 66,765 adults aged ≥65 years (urban-26,485 and rural-40,280) who participated in the household and individual surveys of the Korea Community Health Survey 2019. Data on the main study variables including social participation, depressive symptoms, and HRQoL were collected from August 16 to October 31, 2019. Multiple linear regression was used to identify the factors affecting HRQoL in urban and rural older adults. Results: The proportion of social participation (χ²=354.69, p<.001) and the level of HRQoL (χ²=12.06, p<.001) were significantly higher in older adults living in urban area than those in rural area. However, there was no significant difference in depressive symptoms between older adults living in urban and rural areas. Multiple linear regression analysis showed that social participation and depressive symptoms were significant predictors of HRQoL in both urban and rural older adults. Conclusion: Our main finding highlights that active participation in social activities and management of depressive symptoms in older adults regardless of living arrangements are crucial to improve HRQoL in later life. Interventions to increase social participation include early assessment of depressive symptoms in the community to promote HRQoL. More longitudinal studies are needed to identify the factors associated with HRQoL between older adults living in urban and rural areas while considering neighborhood environment and living arrangements.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.167-175
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• 2018

Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea.

• Journal of Preventive Medicine and Public Health
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• v.55 no.5
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• pp.436-443
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• 2022

Objectives: Previous studies have reported that self-neglect, which may be a sign of elder abuse, can result in suicide among older adults. The signs of self-neglect and its impact on the risk of suicide may differ by gender. Thus, this study explored the association between self-neglect and suicide risk in older Korean adults and examined the potential moderating effect of gender on this relationship. Methods: Data were collected from 356 Korean adults aged 65 or older through an online survey. Multiple regression analysis was used to test the research hypothesis. First, the associations between 4 sub-dimensions of self-neglect (i.e., daily life management issues, personal hygiene issues, financial management issues, and relational issues) and suicidal ideation were examined. Then, the moderating effect of gender on these relationships was investigated by including interaction terms. Results: Self-neglect was significantly associated with suicidal ideation in older adults. Aspects of self-neglect related to daily life management and relational factors were key predictors of suicidal ideation. Gender significantly moderated the effect of the relational dimension of self-neglect on suicidal ideation. The relational dimension of self-neglect was more strongly associated with suicidal ideation in older women than in older men. Conclusions: The findings suggest the importance of screening older adults with signs of self-neglect for suicide risk. Special attention should be paid to older women who experience relational issues as a high-risk group for suicidal ideation. Public programs and support systems should be established to improve daily life management and promote social relationships among older adults.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.428-437
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• 2015

Purpose: The aim of this study was to describe health status and to identify the factors related to health behavior in older adults in South Korea. Methods: A cross-sectional survey was conducted with a convenience sample of 186 older people (mean age =68.2yrs, 65.1% Female) registered at one senior center. Data were collected by self-report questionnaires or through face to face interview. The instruments were the Modified Health Behavior Assessment Scale, Stanford Research Instruments for Chronic Disease, Self-Efficacy, SOF Frailty Index and Quality of life questionnaire. The data were analyzed using t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. Results: 58.6% older adults perceived their health status positively. Education level and economic status were significantly related to health behaviors of older adults. Self-rated health, sleep, stress, quality of life, health distress, depression, and frailty were significantly correlated with the health behaviors of older adults. Frailty, education level, and sleep disturbance were the significant factors predicting the health behaviors. Conclusion: The findings from this study suggest that nurses should take into consideration education level of older adults to promote their health behaviors and health promotion program which focuses on maintaining the quality of sleep and preventing frailty.

• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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• pp.362-365
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• 2010

2010 is the year when the Korean baby boomer generation faces retirement. With the need for affective strategies to keep this population healthy, the government has placed much effort to increase the regular physical activity (PA) level of older adults. Yet the prevalence of active seniors is still relatively low. This paper reviews the recent government strategies and efforts to enhance the physical activity levels of older adults and the PA programs provided in the community settings by major organizations and institutions. In addition, the problems of the current approaches are shown, and based on a review, the author provides five suggestions for promoting the PA level of older adults as follows. First, specific physical activity goals and objectives for older adults should be included in the National Health Plan 2020. Second, the recommendations for PA for seniors, which include a proper intensity, duration and frequency of exercise, should be provided. Third, the role of organizations and institutions should be rearranged for the proper dissemination of government provided community-based exercise programs. Fourth, a standard quality-control system should be provided, and finally, an evidence-based exercise program, which should be specifically created for the older Korean population, should be developed. Physical activity offers opportunities for people to extend the years of their active independent life and reduce functional limitations. To maximize the effects of government efforts to promote PA for seniors, we feel the comments provided in this paper should be closely examined.

• The Korean Journal of Rehabilitation Nursing
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• v.19 no.2
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• pp.71-81
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• 2016

Purpose: The purpose of this study was to explore the influence of cognitive function and depressive symptoms on instrumental activities of daily living (IADL) in addition to identify the factors associated with IADL in community-dwelling older adults. Methods: This was a descriptive study with cross-sectional design. Data were collected from July 2013 to June 2014. A total of 143 participants without dementia, depression and disability were enrolled in this study. Cognitive function was measured using Seoul verbal learning test (SVLT), digital span (forward/backward) and fist-edge-palm test. The Korean-IADL and Short Geriatric Depression Scale (S-GDS) were used. Data analysis was performed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and hierarchical regression. Results: Overall, a multiple regression model revealed that approximately 27.4% of total variability in IADL in the sample of community-dwelling older adults could be explained by the significant 12 variables in this model ($R^2=0.274$, F=5.467, p<.001). Age, having religion and cognitive function were the predictors of IADL in community-dwelling older adults. Conclusion: This study suggest that we need to monitor cognitive function in older to maintain the ability for IADL in older adults. Also, individualized program for improving older adults' IADL should be included in nursing intervention.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.24 no.3
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• pp.264-274
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• 2017

Purpose: This study examined the current state of death preparedness and factors related to the death preparedness among community-dwelling older adults in Korea. Methods: A total of 6,879 older adults' data, selected from the Korean National Survey on the Elderly 2014 data, were analyzed. The criteria for selection were responding to the questionnaires directly and normal cognitive function. Stratified sampling logistic regression analysis was conducted on the compiled data. Results: It was seen that 37.3% of older adults were prepared for death; specifically, 28.6% had arranged for resting places, 10.7% had purchased burial clothes, 6.8% had subscribed to mutual aid societies, 0.7% participated in death education, and 0.6% had signed a will. The results of logistic regression indicated that the older adults who were females, older age, religious, highly educated, more satisfied with their economic status, living in rural areas, and participating in more social activities were more likely to prepare for their deaths compared to their counterparts. Conclusion: Education programs that prepare for death need to target marginalized groups in the community, such as male older adults and whose participation in social activities or satisfaction with their economic status are relatively low.

• Research in Community and Public Health Nursing
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• v.30 no.2
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• pp.234-242
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• 2019

Purpose: This study tries to comprehend older adults' perspectives of community supports and health services in a South Korean city and identify important sociodemographic and health characteristics that affect their perspectives. Methods: 166 older adults were involved in this cross-sectional study. Questions on background characteristics and community supports and health services criteria (categorized as service accessibility, offer of services, voluntary support, or emergency care planning) based upon the WHO's Age-Friendly Cities Guide were used. The data were analyzed using paired and independent t-tests, one-way ANOVA, and hierarchical multiple regression analyses. Results: emergency care planning was rated as the most important by the participants (mean age=76.24 years, 22.9% male), while its current level of performance was lowly appraised (p<.001). The rated importance for each category differed based on individual characteristics. Depression (p=.016), older age (p=.012), and restricted network type (p=.039) were significantly related to ascribing a higher degree of importance to community services. Conclusion: Community initiatives are warranted to optimize emergency care for older adults. This planning must be based on the unique characteristics of older adults in coordination with supportive resources. In addition, comprehensive assessments are warranted before implementing action plans to ensure that the multi-dimensional problems of older adults are incorporated.

• Korean Journal of Applied Biomechanics
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• v.31 no.4
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• pp.259-269
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• 2021

Objective: The purpose of this systematic review and meta-analysis was to investigate age-related bimanual coordination functions in older adults. Method: Thirteen studies that compared bimanual coordination functions in older adults with those in healthy young adults qualified for this meta-analysis. We additionally categorized 21 total comparisons from the 13 qualified studies into two types of task-related moderator variables: (1) kinematic versus kinetic movements and (2) symmetry versus asymmetry movements. Results: Random effects model meta-analysis found that older adults revealed significant bimanual coordination impairments as compared with young adults (Hedges's g = -0.771; p < .0001; I² = 74.437%). We additionally confirmed specific bimanual coordination deficits using two moderator variables: 1) kinematic (Hedges's g = -0.884; p < .0001; I² = 0.000%) and kinetic (Hedges's g = -0.666; p = .023; I² = 86.170%). 2) symmetry (Hedges's g = -0.712; p = .001; I² = 74.291%) and asymmetry (Hedges's g = -0.817; p < .0001; I² = 76.322%). The moderator variable analysis indicated older adults indicated bimanual coordination deficits in the upper extremities than healthy young adults while performing kinematic bimanual coordination tasks and asymmetry coordination tasks. Conclusion: These findings suggest that developing motor rehabilitation programs based on asymmetric bimanual movement task for enhancing interlimb coordination functions of older adults may be crucial for increasing their independence in everyday activities. Given that elderly revealed the deficits in lower extremities coordination when older adults perform gait, posture, and balance, future studies should estimate lower limb coordination functions in elderly people.

• Journal of Korean Clinical Nursing Research
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• v.27 no.1
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• pp.77-84
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• 2021

Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m². Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.