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Volume 41(1); January 2020

Editorial

KLoSA—Korean Longitudinal Study of Aging
Jungun Lee
Korean J Fam Med 2020;41(1):1-2.   Published online January 20, 2020
DOI: https://doi.org/10.4082/kjfm.41.1E

Citations

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    Jong Wan Park, Chang Woo Ko, Diane Youngmi Lee, Jae Chul Kim
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    HyunJee Park, Jinho Kim
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    Haibo Lin, Yihan Xu, Yueming Song
    Heliyon.2024; 10(22): e38666.     CrossRef
  • Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006–2020)
    Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon, Jong-Uk Won
    Journal of Epidemiology and Community Health.2023; 77(6): 355.     CrossRef
  • Change in functional disability and its trends among older adults in Korea over 2008–2020: a 4-year follow-up cohort study
    Van Cuong Nguyen, Gwi-Ryung Son Hong
    BMC Geriatrics.2023;[Epub]     CrossRef
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    BMJ Open.2022; 12(8): e060913.     CrossRef
  • The neighborhood effect of cognitive function on self-rated health: A population-based observational study
    Jae-Hyun Kim
    Archives of Gerontology and Geriatrics.2021; 93: 104285.     CrossRef
  • Body mass index, performance on activities of daily living and cognition: analysis in two different populations
    Miguel Germán Borda, Luis Carlos Venegas-Sanabria, Elkin Garcia-Cifuentes, Ronald Camilo Gomez, Carlos Alberto Cano-Gutierrez, Diego Alejandro Tovar-Rios, Vera Aarsland, Khadija Khalifa, Alberto Jaramillo-Jimenez, Dag Aarsland, Hogne Soennesyn
    BMC Geriatrics.2021;[Epub]     CrossRef
  • 6,289 View
  • 156 Download
  • 8 Web of Science
  • 8 Crossref

Review Article

Cigarette Smoking in South Korea: A Narrative Review
Rebekah Gunter, Edwin Szeto, Se-Hoon Jeong, Sooyeon (Aly) Suh, Andrew J. Waters
Korean J Fam Med 2020;41(1):3-13.   Published online June 13, 2019
DOI: https://doi.org/10.4082/kjfm.18.0015
Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.

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    Dararat Eksombatchai, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Hongjo Choi, Young Ae Kang
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    Youngmee Kim, Won-Kyung Cho
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    Tobacco Induced Diseases.2023; 21(February): 1.     CrossRef
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  • 15,759 View
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Original Articles

Effect of Weight Changes on the Development of Erosive Esophagitis
Tae-Heum Chung, Jiho Lee, In-Du Jeong, Kun-Chul Lee
Korean J Fam Med 2020;41(1):14-19.   Published online January 9, 2020
DOI: https://doi.org/10.4082/kjfm.19.0003
Background
Gastroesophageal reflux disease is highly prevalent among overweight and obese individuals. This study aimed to investigate the effect of weight change on the development of erosive esophagitis (EE).
Methods
A retrospective review of medical records from a university hospital in South Korea identified 7,123 subjects who underwent routine health checkups in 2012 and 2014. We excluded participants with EE in 2012. Body mass index (BMI) changes were classified as loss, stable, mild gain, or moderate gain.
Results
Mild and moderate weight gain increased the odds of EE development (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.06–1.84 and OR, 2.80; 95% CI, 1.87–4.21, respectively) relative to weight stability. Weight loss decreased the odds of EE development (OR, 0.58; 95% CI, 0.38–0.90) relative to weight stability. After stratifying subjects into three groups by baseline BMI, those with mild and moderate weight gain in the obese group and moderate gain in the overweight group showed increased odds of EE development relative to members of those groups whose weights remained stable (OR, 2.08; 95% CI, 1.29–3.36; OR, 3.92; 95% CI, 1.99–7.73 in obese group, and OR, 3.30; 95% CI, 1.64–6.64 in overweight group, respectively). In comparison, weight loss in the normal weight group decreased the odds of EE development relative to weight stability (OR, 0.38; 95% CI, 0.15–0.97).
Conclusion
Weight gain was positively associated with EE development in overweight or obese individuals. Weight loss was negatively associated with EE development in normal-weight individuals.

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Perceived Barriers to Mammography Adoption among Women in Iran: A Qualitative Study
Shayesteh Shirzadi, Hamid Allahverdipour, Manoj Sharma, Hadi Hasankhani
Korean J Fam Med 2020;41(1):20-27.   Published online February 26, 2019
DOI: https://doi.org/10.4082/kjfm.18.0054
Background
Breast cancer is the most commonly diagnosed tumorous cancer and the second leading cause of cancer-related deaths among women worldwide. This study aimed to qualitatively explore the barriers to mammography adoption among Iranian women.
Methods
This study is a qualitative component of a large research project on exploratory sequential mixed method design, utilizing conventional content analysis. In total, 24 participants were selected from among women who had participated in the first phase of the study. Data were collected through in-depth, semi-structured interviews.
Results
Five main themes were extracted, consisting of unawareness of mammography, fear control, priority of mammography needs, inadequate competency of mammography centers, and a sense of losing family support.
Conclusion
Different perceived barriers within various levels (individual, intrapersonal, health systems, and community) play influential roles in women’s decisions to participate in breast cancer screening program, which indicates the cultural aspect of perceived barriers in different communities and countries. The study provides the basis for intervention planning in this regard.

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  • Risk perception regarding social determinants of health among women with breast cancer in Iran: a qualitative study
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    Doaa M Abdel-Salam, Rehab A Mohamed, Hind Y Alyousef, Wahaj A Almasoud, Mashael B Alanzi, Atheer Z Mubarak, Doaa M Osman
    Risk Management and Healthcare Policy.2020; Volume 13: 2553.     CrossRef
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Uncontrolled Blood Pressure in Hypertensive Patients with High Medication Adherence: A Korean Nationwide Population-Based Study
Jiwon Kwon, Chi-Yeon Lim, Minkyeong Kim
Korean J Fam Med 2020;41(1):28-37.   Published online January 8, 2020
DOI: https://doi.org/10.4082/kjfm.19.0051
Background
Uncontrolled blood pressure (BP) is relatively common despite treatment with antihypertensive medication. This study aimed to investigate factors associated with uncontrolled systolic BP (SBP) and diastolic BP (DBP) separately in hypertensive patients with high medication adherence in Korea.
Methods
This population-based cross-sectional study included 3,236 participants in the Korea National Health and Nutrition Examination Survey from 2013 to 2015. Hypertensive patients with high medication adherence were defined when they stated that they were taking antihypertensive medication daily. “Uncontrolled SBP and DBP” were defined as SBP ≥140 mm Hg and DBP ≥90 mm Hg, respectively. Data were analyzed using logistic regression to determine the association between uncontrolled SBP or DBP and various factors.
Results
The prevalence of uncontrolled SBP and uncontrolled DBP was 23.3%, and 9.0%, respectively. In multivariate analysis, uncontrolled SBP was positively associated with older age, female sex, blue-collar occupation or no work (vs. white-collar), presence of a spouse, short sleep duration, frequent heavy alcohol drinking, longer hypertension duration, diabetes, stroke, and missing antihypertensive medication on the examination day, but negatively associated with high stress. Uncontrolled DBP was positively associated with frequent heavy alcohol drinking, but negatively associated with older age, blue-collar occupation or no work (vs. white-collar), and diabetes.
Conclusion
After excluding low medication adherence, we identified various factors associated with uncontrolled SBP or DBP in Korean adults with treated hypertension. There were differences between factors associated with uncontrolled SBP or DBP. Separate analysis of SBP and DBP may help understand the factors involved in BP control.

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    Seung-Won Oh
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    Kyuyoung Han, Yoon Jung Yang, Hyesook Kim, Oran Kwon
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Association of Thyroid Status with Health-Related Quality of Life in Korean Older Adults
Minjung Han, Seulggie Choi, Sarang Kim, Ahryoung Ko, Joung Sik Son, Sang Min Park
Korean J Fam Med 2020;41(1):38-44.   Published online January 6, 2020
DOI: https://doi.org/10.4082/kjfm.19.0054
Background
While hypothyroidism is associated with negative health effects in the general population, older adults with hypothyroidism have better physical function and comparable rates of depression and cognitive impairment relative to their euthyroid counterparts. The aim of this study was to investigate the association between thyroid status and health-related quality of life in Korean older adults.
Methods
In this population-based cross-sectional study, 1,060 adults aged over 60 years were classified by thyroid status into four groups based on their thyroid stimulating hormone (TSH) and free T4 values: overt hypothyroid, subclinical hypothyroid, euthyroid, and subclinical hyperthyroid. The main outcome measure was self-reported health-related quality of life based on the three-level version of the EuroQol-5 dimension (EQ-5D), with utility values of -0.171 and 1.000 corresponding to the worst and best health statuses, respectively. The adjusted means of the EQ-5D three-level version utility values according to thyroid status were determined using a linear regression analysis.
Results
In the adjusted analysis, the overt hypothyroid group showed significantly higher EQ-5D three-level version utility values than did the euthyroid group (0.998 vs. 0.908, P=0.000). In the subgroup analyses by sex, the overt hypothyroid group also showed significantly higher EQ-5D three-level version utility values for both men and women than did the euthyroid group (0.998 vs. 0.940, P=0.008; 0.983 vs. 0.882, P=0.001).
Conclusion
Asymptomatic Korean older adults aged over 60 years with TSH and free T4 values corresponding to overt hypothyroidism have better health-related quality of life than their euthyroid counterparts.

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Trends in Influenza Vaccination Coverage Rates among Korean Cancer Survivors: Analysis of the Korea National Health and Nutrition Examination Survey III–VI
Ye-Seul Kim, Jae-woo Lee, Hee-Taik Kang, Yonghwan Kim, Hyo-Sun You
Korean J Fam Med 2020;41(1):45-52.   Published online November 11, 2019
DOI: https://doi.org/10.4082/kjfm.18.0165
Background
Few studies have reported on the trends in influenza vaccination rates among cancer survivors in Korea. We investigated these trends over a recent 11-year period (2005–2015).
Methods
Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) III– VI (2005–2015). After excluding individuals younger than 40 years of age, the participants included 2,210 cancer survivors (861 men and 1,349 women). We categorized these study participants into four groups according to age and sex.
Results
The influenza vaccination rate decreased significantly among male cancer survivors, with rates of 74.8, 64.7, 56.2, and 55.2% (β coefficient=-0.257, P for trend <0.001) in KNHANES III, VI, V, and VI, respectively. While influenza vaccination rates decreased significantly among older male cancer survivors (≥65 years) (β coefficient=-0.359, P for trend=0.017), they increased among older female cancer survivors (β coefficient=0.375, P for trend=0.011) from 2005 to 2015.
Conclusion
Influenza vaccination rates in older cancer survivors significantly decreased in men but increased in women in successive KNHANES phases. Efforts are needed to improve immunization education and awareness, especially in older male cancer survivors.

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Association between Hand Grip Strength and Self-Rated Health in Middle- and Old-Aged Korean Citizens
Sae-Kyun Jang, Jae-Hyun Kim
Korean J Fam Med 2020;41(1):53-60.   Published online December 17, 2019
DOI: https://doi.org/10.4082/kjfm.18.0200
Background
To investigate the relationship between hand grip strength (HGS) and self-rated health in middleand old-aged Korean subjects.
Methods
The data used for this study were derived from the Korean Longitudinal Study of Aging. A total of 9,132 participants were enrolled using the year 2006 as the baseline, with additional data collected throughout the followup period until 2016. Chi-square test and generalized estimating equation regression models were used for data analysis. HGS was measured in a sitting position with the elbow fixed at 90° on both sides using a dynamometer, and calculated using the values measured from both sides. Relative HGS was measured by dividing HGS by the subject’s body mass index. Self-rated health was assessed with the question “How would you rate your current health in general?” and answers were categorized as “excellent,” “moderate,” or “poor.”
Results
HGS was shown to be inversely associated with self-rated health (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.93–0.94; P<0.0001). Patients aged 65 years or older with lower scores were more likely to report poor self-rated health. Similar results were obtained with relative HGS (OR, 0.40; 95% CI, 0.36–0.45; P<0.0001), but standard HGS had better model fitting (quasi-likelihood under independence model criteria=33,890).
Conclusion
HGS may be considered an index for the diagnosis of sarcopenia and may also affect self-rated health, which is a multidimensional indicator of an individual’s health status and can identify patients who may require special attention.

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    Kayoung Lee
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    Jae-Hyun Kim
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    Jungun Lee
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  • 112 Download
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  • 11 Crossref
Detecting Peripheral Arterial Disease in Primary Care: A Population Based Study
Tolga Vural, Makbule Neslişah Tan, Mehtap Kartal, Azize Dilek Güldal
Korean J Fam Med 2020;41(1):61-67.   Published online May 13, 2019
DOI: https://doi.org/10.4082/kjfm.18.0066
Background
Peripheral arterial disease (PAD) can progress silently without any clinical symptoms. Ankle-brachial index (ABI) is the recommended method used in primary care. We aimed to determine the prevalence of PAD and its related risk factors in primary care.
Methods
In this cross-sectional study, 250 participants aged ≥45 years were recruited randomly from the registered patients of family health center in a district of Izmir, Turkey. Patients’ demographic data, PAD symptoms, and PAD risk factors were obtained. The PAD group consisted of patients with ABI levels <0.9; the non-compressible artery (NCA) group consisted of patients with ABI levels >1.3.
Results
The prevalence of PAD was 17.6% (22.5% in women and 11.1% in men), while that of NCA was 15.2% (12.7% in women and 25.0% in men). About 27.3% and 54.5% of patients with PAD did not have claudication and problems with walking distance, respectively. Of the NCA patients, 15.8% had problems with walking distance and 39.5% had claudication. Regression analysis revealed two predictors of PAD (age ≥65 years: odds ratio [OR], 3.51; 95% confidence interval [CI], 1.65–7.47; claudication: OR, 3.41; 95% CI, 1.58–7.39) and three predictors of NCA (age <65 years: OR, 2.55; 95% CI, 1.01–6.45; male sex: OR, 2.40; 95% CI, 1.10–5.25; triglyceride [TG] >200 mg/dL: OR, 4.11; 95% CI, 1.58–10.67).
Conclusion
PAD had a prevalence of 17.6% and was associated with age ≥65 years and claudication. NCA had a prevalence of 15.2% and was associated with age <65 years, TG >200 mg/dL, and male sex.

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    Halis Yılmaz, Seda Arslan Özkul, Kübra Temel Aslan, Pemra Cöbek Ünalan, Çiğdem Apaydın Kaya
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    Cindy P. Porras, Michiel L. Bots, Martin Teraa, Sander van Doorn, Robin W.M. Vernooij
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    Cindy P. Porras, Martin Teraa, Michiel L. Bots, Annemarijn R. de Boer, Sanne A. E. Peters, Sander van Doorn, Robin W. M. Vernooij
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Case Report
Chronic Back Pain in a Young Female Patient: A Case of Ependymoma Originating from the Conus Medullaris
Siti Fairus Asahar, Khasnur Abd Malek, Wan Najwa Wan Mohd Zohdi, Alan Basil Peter
Korean J Fam Med 2020;41(1):68-72.   Published online January 6, 2020
DOI: https://doi.org/10.4082/kjfm.18.0157
We present the case of a 14-year-old Malay girl with an ependymoma of the conus medullaris who presented to multiple general practitioner clinics with a 24-month history of chronic low back pain. The pain was symptomatically managed as a simple musculoskeletal pain and sciatica. Further imaging to aid diagnosis was delayed until the appearance of severe pain with neurological deficits. Magnetic resonance imaging revealed an enhancing spinal mass at L1 through L3, and histopathological investigations confirmed the grade II ependymoma according to the World Health Organization classification. She underwent gross resection of the tumor. After the surgery, she developed neurogenic urinary bladder and bowel, which required intermittent self-catheterization, intermittent enema use, and intensive physical therapy.

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  • Bilateral Lumbar Radiculopathy Secondary to Myxopapillary Ependymoma: A Case Report
    Joseph C. D'Angiolillo, Nitesh V. Patel, R. Nick Hernandez, Simon Hanft
    Journal of Chiropractic Medicine.2021; 20(3): 170.     CrossRef
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