In Korea, few studies have been performed on screening instruments for the detection of at-risk drinking and alcohol use disorders in the elderly. This study evaluated the validity of three screening instruments in elderly male drinkers.
The subjects were 242 Korean men aged ≥ 65 years. Face-to-face interviews were used to identify at-risk drinking and alcohol use disorders. At-risk drinking was defined according to the criteria for heavy or binge drinking of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV-text revision. The Alcohol Use Disorder Identification Test (AUDIT), Short Michigan Alcoholism Screening Test-geriatric version (SMAST-G), and cut down, annoyed, guilty, eye-opener (CAGE) questionnaire were used as the alcohol-screening instruments. Based on the diagnostic interview results, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of the instruments were compared.
For identification of at-risk drinking, the AUDIT AUROC demonstrated greater diagnostic power than did those of SMAST-G and CAGE (both P < 0.001). In screening for alcohol use disorders, the AUDIT AUROC was also significantly higher than those of SMAST-G and CAGE (both P < 0.001). The sensitivity and specificity of screening for at-risk drinking with an AUDIT score ≥ 7 were 77.3% and 85.1%, respectively, whereas those for the alcohol use disorders with an AUDIT score ≥ 11 were 91.3% and 90.8%, respectively.
The results suggest that the AUDIT is the most effective tool in identifying problem drinkers among elderly male drinkers.
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This preliminary study is to assess risk factors associated with children's body mass index (BMI) and their changes over a 2-year period based on the analysis of the Obesity and Metabolic Disorders Cohort in Childhood registry.
A total of 1,504 children comprised of 474 1st graders and 1,030 4th graders were included in the study. Data on physical activity, dietary intake, and socioeconomic status were obtained through self-administered questionnaires, and height and weight were measured annually for 2 years.
In a cross-sectional analysis, BMI of 1st graders was associated with higher parental BMI (both P < 0.001) and frequent snack consumption (P = 0.049). BMI of 4th graders was additionally associated with shorter sleep duration (P = 0.001), lower household income (P = 0.016), higher fat intake (P = 0.017), and frequent meal skipping (P = 0.020). During a 2-year follow-up, BMI increased by 0.8 ± 1.4 kg/m2 in 1st graders and by 1.3 ± 1.4 kg/m2 in 4th graders. In a longitudinal analysis, higher exercise frequency (P = 0.007), shorter sleep duration (P = 0.027), lower household income (P = 0.002), and higher paternal BMI (P = 0.002, 0.043) were significant predictors of BMI changes in the 1st graders whereas only higher maternal BMI (P=0.035), and frequent snack consumption (P = 0.010) were predictors for the 4th graders BMI changes.
Our findings indicate that parental obesity, short sleep duration, low socioeconomic status, and frequent snacking are associated with BMI and BMI changes.
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Estimation of physical activity contributes to early screening and prevention of decrease in body function. This study was conducted to examine the reliability and validity of the International Physical Activity Questionnaire (IPAQ) short form in elderly people.
A total of 55 outpatients of 65 years old or older participated in this study. Physical activity over the last seven days was recorded on the IPAQ short form. Responses were converted to metabolic equivalent task minutes per week. The IPAQ short form was validated against accelerometer measurements as a gold standard. The test-retest method was performed over a two-week interval to examine the reliability of the IPAQ.
The more physically active by the IPAQ short form, the higher the measured value of the accelerometer (P < 0.001). Pearson's correlation coefficient was 0.43 for the correlation between the results of two measurements. Spearman Rho coefficients and Kappa values of test-retest reliability in five elements (vigorous days, vigorous minutes, moderate days, moderate minutes, and walk days) were 0.299-0.605 and 0.307-0.418, respectively.
The validity of the IPAQ short form was proven, but the reliability was found to be low. Nevertheless, IPAQ short form seems worthwhile tool for the measurement of physical activity levels, concerning daily variation in physical activity of the elderly.
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Testosterone levels are decreased in diabetic patients and recent studies have suggested that high-normal fasting glucose is a risk factor for cardiovascular disease. To further elucidate the relationship between plasma glucose and testosterone, we investigated the association between fasting plasma glucose (FPG) and endogenous sex hormones (serum total testosterone, sex hormone binding globulin, estradiol, and the ratio of testosterone to estradiol) in non-diabetic and pre-diabetic men.
This study included 388 men (age ≥ 40 years) who visited the health promotion center of a university hospital from May 2007 to August 2008. The subjects were divided into quartiles based on their FPG levels and correlation and multiple linear regression analyses were performed. Q1 (65 mg/dL ≤ FPG < 88 mg/dL), Q2 (88 mg/dL ≤ FPG < 94 mg/dL), Q3 (94 mg/dL ≤ FPG < 100 mg/dL) and Q4 (100 mg/dL ≤ FPG < 126 mg/dL).
FPG was independently, inversely associated with total testosterone in the non-diabetic population after adjusting for age, body mass index, smoking, and alcohol consumption (β = -0.082, P < 0.01). Among the quartiles, subjects in the high-normal FPG groups (Q2, Q3, and Q4 with FPG ≥ 88 mg/dL) had significantly decreased testosterone levels when compared with subjects in the normal FPG group (Q1 with FPG < 88 mg/dL, P < 0.005). Sex hormone binding globulin, estradiol and the ratio of testosterone to estradiol were not correlated with FPG.
Our study indicates that high-normal fasting glucose levels are associated with decreased testosterone levels in non-diabetic and pre-diabetic men.
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This study examined the effects of the method of delivery of brief advice on the readiness to change in at-risk drinkers.
The participants were 103 at-risk male drinkers who visited Chungnam National University Hospital for general health examinations. Baseline data on drinking behavior, readiness to change drinking behavior, and sociodemographic characteristics were obtained from a questionnaire. Family physicians gave two minutes of advice by telephone or in-person. The brief advice comprised a simple statement that the patient's drinking exceeded the recommended limits and could lead to alcohol-related problems. It also included advice to moderate one's drinking. One month later, the readiness to change was assessed again by telephone. The improvement in the readiness to change according to each method of delivery was investigated.
Initially, among the 58-patient in-person advice group, 12 patients were in the precontemplation stage, 38 in the contemplation stage, and 8 in the action stage. One month after the advice was given to the patients, the distribution had changed significantly (P < 0.001) to 1, 21, and 36 patients, respectively. Among the 45-patient telephone advice group, 7 patients were in the precontemplation stage, 32 patients were in the contemplation stage, and 6 patients were in the action stage before the advice. The distribution had changed significantly (P < 0.001) to 1, 17, and 27 patients, respectively, 1 month after the advice.
These results suggest that brief advice by family physicians is effective in improving the readiness to change of at-risk drinkers, regardless of the delivery method.
Blood lipid profiles have been suggested to be a risk factor for osteoporosis. However, the association between lipid profiles and bone mineral density (BMD) is still unclear. This study aimed to evaluate an association between blood lipid profiles and BMD through both a cross-sectional and a longitudinal study.
Study subjects were 958 postmenopausal Korean women who have repeatedly undertaken laboratory tests and BMD measurements at lumbar spine and femur neck with an interval of 7.1 years. The associations between lipid profiles and BMD were examined using Spearman correlation analysis with an adjustment for age, smoking, alcohol drinking, physical activity, body mass index, and follow-up duration.
Lumbar spine BMD was not associated with total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HLD-C) regardless of when the measurement was performed. In an analysis using data measured at the beginning of the study, femur neck BMD was not associated with TC and LDL-C. However, femur neck BMD showed weak but significantly positive correlation with HDL-C (correlation coefficient, 0.077; 95% confidence interval, 0.005 to 0.149). When the analysis was repeated with data measured at the end of the follow-up, there was no significant correlation between femur neck BMD and any lipid profile. In addition, change in femur neck BMD during follow-up was not associated with the change in lipid profiles.
Although further study with a consideration of calcium intake and osteoporosis medication seems necessary, this study found no association between serum lipid profiles and BMD in postmenopausal Korean women.
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Metabolite Profiling of Osteoporosis and Atherosclerosis in Postmenopausal Women: A Cross-Sectional Study
The Papanicolaou (Pap) smear test is an effective screening test for the early detection of uterine cervical cancer. The Pap test still plays an important role in Korean elderly women, as uterine cervical cancer remains a frequent form of cancer and an important cause of death. However, the participation rate and other factors related to the Pap test in Korean elderly women have been studied insufficiently.
This study included 654 individuals aged 65 and over who completed a cervical cancer screening questionnaire from the Third Korean National Health and Nutrition Examination Survey 2005. Using multiple logistic regression, odds ratios and confidence intervals for the association between attendance of the Pap test and sociodemographic or health-related factors were calculated.
One hundred and eleven individuals (17.0%) of the study population showed compliance with Pap testing within the previous 2 years. We recognized that the most elderly women (75 years and over) or those with lower levels of education were less likely to have had the test.
Primary health care providers need to make efforts to improve attendance rates of Pap smear screening in Korean elderly women, individually taking into account previous Pap results, life expectancy, risk factors for cervical cancer, and preferences. More attention will especially be needed among the eldest elderly or less educated elderly women.
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Highly active antiretroviral therapy (HAART), which restores specific immune responses, may paradoxically cause an inflammatory reaction known as immune reconstitution inflammatory syndrome (IRIS). We report a patient with acquired immune deficiency syndrome, who presented
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