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"Cognition"

Review Article

Preventive Measures against the Development of Dementia in Old Age
Israel Oluwasegun Ayenigbara
Korean J Fam Med 2022;43(3):157-167.   Published online May 20, 2022
DOI: https://doi.org/10.4082/kjfm.21.0030
Dementia is a neurological condition characterized by numerous types of central nervous system diseases, which gradually deteriorates an individual’s reasoning, rational thinking, and judgment abilities. As a serious public health concern that currently affects more than 50 million older adults, dementia is one of the most significant causes of incapacity, disability, and dependency among older adults. As new cases are expected to increase exponentially in the next three decades, dementia, which is not a normal feature of healthy aging despite the fact that it generally affects older adults disproportionately, requires enormous management and care efforts due to its associated socioeconomic, psychological, and physical burdens that involve the patient, their caregivers, guardians, family members, and society at large. Presently, there is no cure for dementia; however, this condition could be prevented. This narrative review aimed to provide a broad overview of studies detailing the alternative lifestyle modification-centered preventive measures against dementia. A comprehensive search of key databases to find articles related to this topic revealed that participating in regular physical activities, healthy eating and dieting, avoiding all forms of smoking, avoiding air pollutants, halting or reducing alcohol consumption, exercising the mind and being socially dynamic, getting enough rest and establishing good sleeping habits, infection prevention, stress prevention, avoidance of injuries, preventing the effects of social isolation and lockdowns, continuing education, and depression prevention are protective measures against the development of dementia.

Citations

Citations to this article as recorded by  
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • A Genome-Wide Association Study of Dementia Using the Electronic Medical Record
    Xiaowen Cao, Yao Dong, Li Xing, Xuekui Zhang
    BioMedInformatics.2023; 3(1): 141.     CrossRef
  • Health promotion: the essence of primary healthcare
    Sung Sunwoo
    Journal of the Korean Medical Association.2022; 65(12): 772.     CrossRef
  • 5,796 View
  • 128 Download
  • 2 Web of Science
  • 3 Crossref
Original Articles
Background
Decreased physical performance, such as weakened handgrip strength and cognitive decline, is associated with disability and premature death in old age. We investigated the association between handgrip strength and cognitive impairment in Korean elderly adults with normal cognitive function.
Methods
This prospective study used the database from the Korean Longitudinal Study of Ageing. The participants included 2,378 adults aged 65 years or older with normal cognitive function (Korean Mini-Mental Status Evaluation [K-MMSE] score ≥21). Using a mixed-effects model, we examined the associations at baseline and over an 8-year follow-up period between handgrip strength and K-MMSE score. We investigated handgrip strength as a predictor of change in cognitive function.
Results
This study included 1,138 women (mean maximum handgrip strength 19.2 kg, mean K-MMSE score 25.1) and 1,240 men (mean maximum handgrip strength 30.7 kg, mean MMSE score 26.2). The baseline handgrip strength was positively associated with the baseline K-MMSE score (b=0.18, P<0.001). Using a mixed-effects model, we found that higher handgrip strength at baseline can predict MMSE scores positively over time (b=0.14, P<0.001) and the change of handgrip strength over time was a predictor of high MMSE scores over the study period (b=0.01, P<0.01).
Conclusion
We observed significant associations between baseline handgrip strength and baseline and change of cognition, as well as the longitudinal influence of handgrip strength on the change of cognitive function in elderly Korean adults with normal cognitive function.

Citations

Citations to this article as recorded by  
  • Lower limb strength and depression: a national cross‐sectional study of an elderly population in China
    Taoyang Cai, Shangjie Ge‐Zhang, Yanru Liu
    Psychogeriatrics.2025;[Epub]     CrossRef
  • Potential risk factors for mild cognitive impairment among patients with type 2 diabetes experiencing hypoglycemia
    Ruonan Gao, Menglan Zhan, Sujie Ke, Kejun Wu, Guanlian He, Liqin Qi, Xiaoying Liu, Xiaohong Liu, Lijing Wang, Libin Liu
    Diabetes Research and Clinical Practice.2024; 207: 111036.     CrossRef
  • Exploring the Association between Elevated Anxiety Symptoms and Low Skeletal Muscle Mass among Asymptomatic Adults: A Population-Based Study in Republic of Korea
    Eunsoo Kim, Sra Jung, Mi Yeon Lee, Chul-Hyun Park, Sung Joon Cho
    Brain Sciences.2024; 14(5): 438.     CrossRef
  • Handgrip strength is associated with cognitive function in older patients with stage 3-5 chronic kidney disease: results from the NHANES
    Jialing Zhang, Peixin Wang, Qi Pang, Shiyuan Wang, Aihua Zhang
    Scientific Reports.2024;[Epub]     CrossRef
  • Relationship between falls, cognitive decline, and dementia in older adults: Insights from the Korean longitudinal study of aging, 2006–2020
    Soo-Jin Kim, Hyeong-Dong Kim
    Experimental Gerontology.2024; 194: 112481.     CrossRef
  • Enhancing physical function and activity level in malnourished older adults through oral nutrition supplements: a randomized controlled trial
    Ranil Jayawardena, Kalani Weerasinghe, Manoja Gamage, Andrew P. Hills
    BMC Geriatrics.2024;[Epub]     CrossRef
  • The Grip Strength Loss Rate and the Subsequent Cognitive Decline Rate in Older Adults: The Moderating Role of Social Isolation
    Yanzhi Li, Liwan Zhu, Caiyun Zhang, Hao Zhao, Wanxin Wang, Lan Guo, Ciyong Lu, W Quin Yow
    Innovation in Aging.2024;[Epub]     CrossRef
  • Longitudinal Trajectories of Self-Reported Cognitive Function and Associated Factors Among Older Cancer Survivors
    Youn-Jung Son, Kyoung-Hwa Baek, Eun Young Kim
    Western Journal of Nursing Research.2024; 46(9): 674.     CrossRef
  • Does motor functioning mediate the relationship between executive functions and psychological well-being of atypically developing older adults?
    Maria Chiara Fastame, Ilaria Mulas, Valeria Putzu, Gesuina Asoni, Daniela Viale, Irene Mameli, Massimiliano Pau
    Current Psychology.2023; 42(17): 14237.     CrossRef
  • Patterns and risk factors of cognitive decline among community-dwelling older adults in South Korea
    Jinhee Shin, Eunhee Cho
    Archives of Gerontology and Geriatrics.2023; 104: 104809.     CrossRef
  • Handgrip strength is associated with learning and verbal fluency in older men without dementia: insights from the NHANES
    Konstantinos Prokopidis, Panagiotis Giannos, Theocharis Ispoglou, Ben Kirk, Oliver C. Witard, Yannis Dionyssiotis, David Scott, Helen Macpherson, Gustavo Duque, Masoud Isanejad
    GeroScience.2023; 45(2): 1049.     CrossRef
  • The Relationship between Handgrip Strength, Timed Up-and-Go, and Mild Cognitive Impairment in Older People during COVID-19 Pandemic Restrictions
    Jiranan Griffiths, Mathuramat Seesen, Wachiranun Sirikul, Penprapa Siviroj
    Behavioral Sciences.2023; 13(5): 410.     CrossRef
  • INVESTIGATION of the RELATIONSHIP COGNITIVE FUNCTIONS with PHYSICAL ACTIVITY and STRENGTH in HEALTHY MIDDLE-AGED ADULTS
    Umut CANLI, Cem KURT
    The Online Journal of Recreation and Sports.2023; 12(4): 528.     CrossRef
  • Association between Handgrip Strength and Cognitive Function in Older Adults: Korean Longitudinal Study of Aging (2006–2018)
    San Lee, Jae Won Oh, Nak-Hoon Son, Woojin Chung
    International Journal of Environmental Research and Public Health.2022; 19(3): 1048.     CrossRef
  • A Link between Handgrip Strength and Executive Functioning: A Cross-Sectional Study in Older Adults with Mild Cognitive Impairment and Healthy Controls
    Fabian Herold, Berit K. Labott, Bernhard Grässler, Nicole Halfpaap, Corinna Langhans, Patrick Müller, Achraf Ammar, Milos Dordevic, Anita Hökelmann, Notger G. Müller
    Healthcare.2022; 10(2): 230.     CrossRef
  • Social, behavioural, and functional characteristics of community‐dwelling South Korean adults with moderate and severe cognitive impairment
    Sanghun Nam, Brian Downer, Suyeong Bae, Ickpyo Hong
    International Journal of Methods in Psychiatric Research.2022;[Epub]     CrossRef
  • Increased cortisol levels caused by acute resistance physical exercise impair memory and learning ability
    José-Luis Bermejo, Raúl Valldecabres, Israel Villarrasa-Sapiña, Gonzalo Monfort-Torres, Adrià Marco-Ahulló, Bruno Ribeiro Do Couto
    PeerJ.2022; 10: e13000.     CrossRef
  • Handgrip Strength and Cognitive Function among Elderly Koreans: Insights from the Korean Longitudinal Study of Ageing
    Keuntae Kim, Hyemi Kim
    International Journal of Environmental Research and Public Health.2022; 19(9): 5262.     CrossRef
  • Relationship between physiological tremor and cognitive function in physically active older women
    Wonil Park, Bokbeom Kim, Jaesung Lee, Gyuseog Hong, Jonghoon Park
    Physical Activity and Nutrition.2022; 26(1): 14.     CrossRef
  • Relationship between handgrip strength, depression and cognitive functioning among older adults: Evidence from longitudinal ageing study in India
    T. Muhammad, Priya Maurya
    International Journal of Geriatric Psychiatry.2022;[Epub]     CrossRef
  • Grip Strength Trajectories and Cognition in English and Chilean Older Adults: A Cross-Cohort Study
    Bárbara Angel, Olesya Ajnakina, Cecilia Albala, Lydia Lera, Carlos Márquez, Leona Leipold, Avri Bilovich, Richard Dobson, Rebecca Bendayan
    Journal of Personalized Medicine.2022; 12(8): 1230.     CrossRef
  • Is Obesity Associated with Lower Mini Mental Test Scores among Elderly? A Cross Sectional Study
    Nezire İnce, Müjgan Öztürk, Reci Meseri, Halit Tanju Besler
    Journal of the American Nutrition Association.2022; 41(6): 600.     CrossRef
  • Combination of gait speed and grip strength to predict cognitive decline and dementia
    Suzanne G. Orchard, Galina Polekhina, Joanne Ryan, Raj C. Shah, Elsdon Storey, Trevor T.‐J. Chong, Jessica E. Lockery, Stephanie A. Ward, Rory Wolfe, Mark R. Nelson, Christopher M. Reid, Anne M. Murray, Sara E. Espinoza, Anne B. Newman, John J. McNeil, Ta
    Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring.2022;[Epub]     CrossRef
  • Triglyceride Level- and MTHFR-Specific Mediation Effect of Handgrip Strength on the Association of Dietary Protein Intake and Cognitive Function in the Chinese Elderly
    Ling Huang, Qian Liu, Jingzhu Fu, Dezheng Zhou, Yue Sun, Huilian Duan, Tong Yang, Jing Zhao, Zehao Wang, Zhenshu Li, Cuixia Dong, Ning Xu, Qinghan Ren, Guoquan Zhang, Wen Li, Fei Ma, Jing Yan, Yue Du, Huan Liu, Changqing Sun, Guangshun Wang, Guowei Huang,
    Current Alzheimer Research.2022; 19(9): 658.     CrossRef
  • Is dynapenia associated with the onset and persistence of depressive and anxiety symptoms among older adults? Findings from the Irish longitudinal study on ageing
    Andre F. Carvalho, Michael Maes, Marco Solmi, Andre R. Brunoni, Shannon Lange, M. Ishrat Husain, Paul Kurdyak, Jürgen Rehm, Ai Koyanagi
    Aging & Mental Health.2021; 25(3): 468.     CrossRef
  • From cognitive to motor impairment and from sarcopenia to cognitive impairment: a bidirectional pathway towards frailty and disability
    Giorgio Basile, Alberto Sardella
    Aging Clinical and Experimental Research.2021; 33(2): 469.     CrossRef
  • Challenging the relationship of grip strength with cognitive status in older adults
    Andrew Hooyman, Michael Malek‐Ahmadi, Elizabeth B. Fauth, Sydney Y. Schaefer
    International Journal of Geriatric Psychiatry.2021; 36(3): 433.     CrossRef
  • Trajectories of Handgrip Strength and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging
    Kyung Hyun Bae, Yong Ho Jo, Dong Ryul Lee, Jungun Lee
    Korean Journal of Family Medicine.2021; 42(1): 38.     CrossRef
  • Cortical hemodynamics as a function of handgrip strength and cognitive performance: a cross-sectional fNIRS study in younger adults
    Fabian Herold, Tom Behrendt, Alexander Törpel, Dennis Hamacher, Notger G. Müller, Lutz Schega
    BMC Neuroscience.2021;[Epub]     CrossRef
  • Associations of Handgrip Strength and Handgrip Strength Asymmetry With Depression in the Elderly in Korea: A Cross-sectional Study
    Kyungduk Hurh, Yoonsik Park, Gyu Ri Kim, Sung-In Jang, Eun-Cheol Park
    Journal of Preventive Medicine and Public Health.2021; 54(1): 63.     CrossRef
  • Interactions Between Handgrip Strength and Serum Folate and Homocysteine Levels on Cognitive Function in the Elderly Chinese Population
    Yongjie Chen, Yue Du, Zhuoyu Sun, Qian Liu, Changqing Sun, Hongyan Lin, Mengdi Jin, Jingzhu Fu, Fei Ma, Wen Li, Huan Liu, Xumei Zhang, Guangshun Wang, Guowei Huang, Anne Ording
    Journal of Alzheimer's Disease.2021; 80(4): 1503.     CrossRef
  • Associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old
    Anying Bai, Weihao Xu, Jing Sun, Juan Liu, Xinli Deng, Linna Wu, Xiao Zou, Jing Zuo, Lin Zou, Yunxia Liu, Hengge Xie, Xiaohong Zhang, Li Fan, Yixin Hu
    BMC Geriatrics.2021;[Epub]     CrossRef
  • How are academic achievement and inhibitory control associated with physical fitness, soil-transmitted helminth infections, food insecurity and stunting among South African primary schoolchildren?
    Markus Gerber, Christin Lang, Johanna Beckmann, Rosa du Randt, Stefanie Gall, Harald Seelig, Kurt Z. Long, Sebastian Ludyga, Ivan Müller, Madeleine Nienaber, Siphesihle Nqweniso, Uwe Pühse, Peter Steinmann, Jürg Utzinger, Cheryl Walter
    BMC Public Health.2021;[Epub]     CrossRef
  • Low Serum Vitamin E Level Associated with Low Hand Grip Strength in Community-Dwelling Adults: Korean National Health and Nutrition Examination Survey (KNHANES VII) 2016–2018
    Yongjae Kim, Sungjae Shin, Namki Hong, Yumie Rhee
    Nutrients.2021; 13(5): 1598.     CrossRef
  • Association of Cardiovascular Disease Risk and Physical Fitness with Cognitive Impairment in Korean Elderly Women
    Inhwan Lee, Hyunsik Kang
    The Korean Journal of Sports Medicine.2021; 39(2): 51.     CrossRef
  • Predictors of Changes in Cognitive Function in Older Korean Adults: The 2006–2018 Korean Longitudinal Study of Aging
    Minjeong Kang, Inhwan Lee, Haeryun Hong, Jeonghyeon Kim, Hyunsik Kang
    International Journal of Environmental Research and Public Health.2021; 18(12): 6345.     CrossRef
  • A Multimodal Risk Network Predicts Executive Function Trajectories in Non-demented Aging
    Shraddha Sapkota, G. Peggy McFall, Mario Masellis, Roger A. Dixon
    Frontiers in Aging Neuroscience.2021;[Epub]     CrossRef
  • Cognitive Dispersion Predicts Grip Strength Trajectories in Men but not Women in a Sample of the Oldest Old Without Dementia
    Tamlyn Watermeyer, Fernando Massa, Jantje Goerdten, Lucy Stirland, Boo Johansson, Graciela Muniz-Terrera, Steven M Albert
    Innovation in Aging.2021;[Epub]     CrossRef
  • Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients
    Fabrizia Lattanzio, Valentina Corigliano, Luca Soraci, Alessia Fumagalli, Graziano Onder, Stefano Volpato, Antonio Cherubini, Carmelinda Ruggiero, Annalisa Cozza, Francesco Guarasci, Andrea Corsonello
    Frontiers in Medicine.2021;[Epub]     CrossRef
  • Thumb Radial Abduction Angle and its Association with Handgrip Strength, Dexterity and Carpel Tunnel Syndrome Susceptibility among Saudi Dental Students
    WA Wahhas, ZH Ramadhan, TS Ain, RA Togoo
    Nigerian Journal of Clinical Practice.2021; 24(3): 299.     CrossRef
  • KLoSA—Korean Longitudinal Study of Aging
    Jungun Lee
    Korean Journal of Family Medicine.2020; 41(1): 1.     CrossRef
  • Handgrip strength, dynapenia, and mental health in older Koreans
    Hye-Mi Noh, Yong Soon Park
    Scientific Reports.2020;[Epub]     CrossRef
  • Grip Strength as a Cardiometabolic Marker
    Jungun Lee
    Korean Journal of Family Medicine.2020; 41(5): 271.     CrossRef
  • Dual-Task Training Affect Cognitive and Physical Performances and Brain Oscillation Ratio of Patients With Alzheimer’s Disease: A Randomized Controlled Trial
    Elnaz Parvin, Fatemeh Mohammadian, Sadegh Amani-Shalamzari, Mahdi Bayati, Behnaz Tazesh
    Frontiers in Aging Neuroscience.2020;[Epub]     CrossRef
  • 11,811 View
  • 178 Download
  • 46 Web of Science
  • 44 Crossref
The Association between Frailty and Cognition in Elderly Women
Ji-Young Kang, Cheol-Hwan Kim, Eun-Ju Sung, Ho-Cheol Shin, Woon-Jung Shin, Keun-Hyeong Jung
Korean J Fam Med 2016;37(3):164-170.   Published online May 26, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.3.164
Background

Frailty refers to the loss of physiologic complexity and the associated decline in ability to withstand stressors as one gets older. It is defined as unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity. According to several western studies, frailty is associated with cognitive impairment, but there have been few studies about the relationship between frailty and cognitive impairment in Korea. Thus, the purpose of this study is to analyze the relationship between cognition and factors related to frailty such as grip strength, walking speed, physical activity, and depression, among female patients older than 65 in Korea.

Methods

A total of 121 subjects among the outpatients of the department of family medicine at Kangbuk Samsung Hospital who did not meet the exclusion criteria were included in this study. We divided the participants into 2 groups, according to the Korean version of the Montreal Cognitive Assessment (MoCA) score: 1 group with subjects that had normal cognition and the other group with patients that had impaired cognition. A comparison was made between the 2 groups in regards to the factors related to frailty, and we completed equation that predicting cognition from the frailty related factors.

Results

Compared with the impaired cognition group, the subjects in the normal cognition group had higher hand strength, and walked faster (P<0.001). There was no statistically significant difference in physical activity between the 2 groups (P=0.19). When multiple linear regression analysis was performed using age, grip strength, and walking speed as the predictor variables and MoCA score as the dependent variable, the regression coefficients were calculated to be: -0.2015, 0.2294, 1.2372, and -0.1436, respectively (P<0.05).

Conclusion

In Korean female patients who are older than 65 years of age, cognition tends to decline as grip strength decreases, walking speed gets slower, depression becomes more severe, and as age increases.

Citations

Citations to this article as recorded by  
  • Association between the hemoglobin-to-red cell distribution width ratio and three-month unfavorable outcome in older acute ischemic stroke patients: a prospective study
    Luwen Huang, Linlin Li, Qing-rong Ouyang, Ping Chen, Ming Yu, Lei Xu
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • The prevalence and factors associated with sarcopenia in Thai older adults: A systematic review and meta-analysis
    Phatcharaphon Whaikid, Noppawan Piaseu
    International Journal of Nursing Sciences.2024; 11(1): 31.     CrossRef
  • Dietary Inflammatory and Its Association with Cognitive Frailty Among Community-Dwelling Older Adults in Klang Valley
    Bong Jun Fae Felicia, Rasyidah Abdul Rahman, Nurul Hidayah Md Fadzil, Suzana Shahar
    Malaysian Journal of Medicine and Health Sciences.2023; 19(4): 273.     CrossRef
  • Cortical thickness of the rostral anterior cingulate gyrus is associated with frailty in patients with end-stage renal disease undergoing hemodialysis in Korea: a cross-sectional study
    Sang Hyun Jung, Jong Soo Oh, So-Young Lee, Hye Yun Jeong
    Journal of Yeungnam Medical Science.2023; 40(4): 381.     CrossRef
  • Deficits in rate of force production during multifinger tasks are associated with cognitive status
    Richard G. Carson, Eimíle Holton
    International Journal of Geriatric Psychiatry.2022;[Epub]     CrossRef
  • The Parallel Mediation Effects of Depression, Well-Being, and Social Activity on Physical Performance and Frailty in Community-Dwelling Middle-Aged and Older People
    Eva Berthy Tallutondok, Chia-Jung Hsieh, Pei-Shan Li, Tomasz Kostka
    Current Gerontology and Geriatrics Research.2022; 2022: 1.     CrossRef
  • Predictors of Changes in Cognitive Function in Older Korean Adults: The 2006–2018 Korean Longitudinal Study of Aging
    Minjeong Kang, Inhwan Lee, Haeryun Hong, Jeonghyeon Kim, Hyunsik Kang
    International Journal of Environmental Research and Public Health.2021; 18(12): 6345.     CrossRef
  • Effects of a four-exercise resistance training protocol on functional parameters in sedentary elderly women
    Bruno Bavaresco Gambassi, Clarcson Plácido Conceição dos Santos, Ciro Queiroz, Fabrício Mesquita, Patricia Rakel Santos, Ana Eugênia Araújo Furtado Almeida, Paulo Adriano Schwingel, Fabiano de Jesus Furtado Almeida
    Sport Sciences for Health.2020; 16(1): 99.     CrossRef
  • Grip Strength as a Cardiometabolic Marker
    Jungun Lee
    Korean Journal of Family Medicine.2020; 41(5): 271.     CrossRef
  • Clinical and Neuropsychological Correlates of Prefrailty Syndrome
    Laura Lorenzo-López, Julia Blanco-Fandiño, Nuria Cibeira, Ana Buján, Rocío López-López, Ana Maseda, José Carlos Millán-Calenti
    Frontiers in Medicine.2020;[Epub]     CrossRef
  • Development of a Physiological Frailty Index for the World Trade Center General Responder Cohort
    Ghalib A. Bello, Roberto G. Lucchini, Susan L. Teitelbaum, Moshe Shapiro, Michael A. Crane, Andrew C. Todd
    Current Gerontology and Geriatrics Research.2018; 2018: 1.     CrossRef
  • Body Mass Index and Rural Status on Self‐Reported Health in Older Adults: 2004‐2013 Medicare Expenditure Panel Survey
    John A. Batsis, Karen L. Whiteman, Matthew C. Lohman, Emily A. Scherer, Stephen J. Bartels
    The Journal of Rural Health.2018;[Epub]     CrossRef
  • Increasing use of cognitive measures in the operational definition of frailty—A systematic review
    R. Vella Azzopardi, I. Beyer, S. Vermeiren, M. Petrovic, N. Van Den Noortgate, I. Bautmans, E. Gorus
    Ageing Research Reviews.2018; 43: 10.     CrossRef
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    Jiyoung Kang, Cheolhwan Kim
    Australasian Journal on Ageing.2018;[Epub]     CrossRef
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    A. R. Sousa-Santos, T. F. Amaral
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  • 63 Download
  • 15 Web of Science
  • 15 Crossref
Non-Coronary Patients with Severe Chest Pain Show More Irrational Beliefs Compared to Patients with Mild Pain
Mostafa Bahremand, Mozhgan Saeidi, Saeid Komasi
Korean J Fam Med 2015;36(4):180-185.   Published online July 17, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.4.180
Background

Despite providing insufficient medical evidence of the existence of a real cardiac condition, patients with non-coronary chest pain still interpret their pain incorrectly. The present study, therefore, sought to compare the irrational beliefs in non-coronary patients with mild chest pain against those with severe chest pain.

Methods

A cross-sectional design was used. The statistical population comprised non-coronary patients who presented to the Heart Emergency Center of Kermanshah city, Iran. Using a matching method, 96 participants were selected and studied in two groups of 48. The instruments used were the Comorbidity Index, Brief Pain Index, and the Jones Irrational Beliefs Test (short-form). The multivariate analysis of variance, chi-square test, and t-test were used for data analysis.

Results

Controlling for the effects of age and comorbid conditions, the severity of three types of irrational beliefs, including emotional irresponsibility (P<0.001), hopelessness changes (P<0.001), and problem avoiding (P=0.002) was higher among patients with severe chest pain (according to effect level). However, in terms of demand for approval, no difference was seen between the two groups (P=0.180).

Conclusion

Non-coronary patients with severe chest pain showed a greater number of irrational beliefs in comparison to patients with mild pain. Irrational beliefs are common mental occurrences in patients with non-coronary chest pain, and they should be attended to by health professionals, especially in severe non-coronary chest pain. Further investigation to determine the association between irrational beliefs and non-coronary chest pain is necessary.

Citations

Citations to this article as recorded by  
  • Examining Irrational Beliefs and their Association with the Quality of Life of Students: Evidence from a Cross-Sectional Study
    Ali Reza Yusefi, Omolbanin Atashbahar, Jamshid Bahmaei, Hedyeh Askarpour, Shima Bordbar
    The Open Public Health Journal.2024;[Epub]     CrossRef
  • Which symptoms are the psychopathological core affecting the manifestation of pseudo-cardiac symptoms and poor sleep quality in young adults? Symptoms of personality disorders versus clinical disorders
    Mostafa Bahremand, Saeid Komasi
    Frontiers in Psychology.2022;[Epub]     CrossRef
  • Correlation of Heart Knowledge and Cardiac Risk Factors with Readiness for Lifestyle Modification in Companions of Patients with Cardiovascular Diseases in the West of Iran
    Parvin Ezzati, Shayesteh Salehi
    Middle East Journal of Rehabilitation and Health.2019;[Epub]     CrossRef
  • Heart Knowledge and Risk Perception Profile in Substance Misusers: Partitioning Risky Samples and Determining Correlates: A Cross-Sectional Study
    Mozhgan Saeidi, Mohammad Mahdi Amiri, Mona Azizi, Fyroozeh Dashti, Mostafa Alikhani, Ali Soroush, Saeid Komasi
    Middle East Journal of Rehabilitation and Health Studies.2019;[Epub]     CrossRef
  • Triggers of Substance Abuse Slip and Relapse During Outpatient Treatment in Methadone/Buprenorphine Maintenance Therapy Clinics: A Predictive Model with Emphasis on Treatment-Related Factors
    Saeid Komasi, Mozhgan Saeidi, Mohammad Mehdi Amiri, Nasrin Nazeie, Nasim Shams Alizadeh, Ali Soroush
    Jundishapur Journal of Health Sciences.2017;[Epub]     CrossRef
  • Comparison of Depression, Anxiety, and Stress Between Mild and Severe Non-cardiac Chest Pain
    Mostafa Bahremand, Mozhgan Saeidi, Fariba Takallo, Saeid Komasi
    Thrita.2016;[Epub]     CrossRef
  • Cognitive Restructuring Based on Metaphor Therapy to Challenge the Irrational Beliefs of Drug Addicts Undergoing Buprenorphine Treatment
    Saeid Komasi, Mozhgan Saeidi, Ali Zakiei, Mohammad Mehdi Amiri, Bahareh Soltani
    International Journal of High Risk Behaviors and Addiction.2016;[Epub]     CrossRef
  • Irrational beliefs predict pain/discomfort and emotional distress as a result of pain in patients with non-cardiac chest pain
    Saeid Komasi, Ali Soroush, Mostafa Bahremand, Mozhgan Saeidi
    The Korean Journal of Pain.2016; 29(4): 277.     CrossRef
  • Non-coronary chest pain does not affect long-term mortality: a prospective, observational study using a matched population control
    Staffan Nilsson, Petter Järemo
    BMC Family Practice.2016;[Epub]     CrossRef
  • Comments on Statistical Issues in September 2015
    Kyung Do Han, Yong Gyu Park
    Korean Journal of Family Medicine.2015; 36(5): 258.     CrossRef
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  • 19 Download
  • 6 Web of Science
  • 10 Crossref
Correlation between Frailty and Cognitive Function in Non-Demented Community Dwelling Older Koreans
Sun Kim, Jun Li Park, Hwan Sik Hwang, Yeon Pyo Kim
Korean J Fam Med 2014;35(6):309-320.   Published online November 21, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.6.309
Background

Frailty and cognitive impairment are considered the most common and yet least understood conditions in older adults. This study was conducted to investigate the correlation between frailty and cognitive function in non-demented older Koreans.

Methods

Korean Mini-Mental Status Examination (K-MMSE) scores and Cardiovascular Health Study Frailty Indices were obtained for 486 older adults aged 65 and over who registered at six senior welfare centers in Seoul and Gyeonggi province. Multiple linear regression was performed to identify the association between frailty and K-MMSE scores.

Results

Of the 486 older adults, 206 (42.4%) were robust, 244 (50.2%) were prefrail, and 36 (7.4%) were frail. Prevalence of cognitive impairment (K-MMSE ≤ 23) was 6.3% in the robust group, 16.8% in the prefrail group, and 30.6% in the frail group (P < 0.001), and mean K-MMSE score was 27.5 ± 2.2, 26.5 ± 3.1, and 23.7 ± 5.3, respectively (P < 0.001). Frailty tended to be associated with lower MMSE scores (B = -1.92, standard error, 0.52; P < 0.001).

Conclusion

Frailty was found to be correlated with cognitive impairment in non-demented older Koreans. However, further cohort studies are required to determine the association between frailty and cognitive function.

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The Association between Pain and Depression, Anxiety, and Cognitive Function among Advanced Cancer Patients in the Hospice Ward
Hae Jin Ko, Se Jung Seo, Chang Ho Youn, Hyo Min Kim, Seung Eun Chung
Korean J Fam Med 2013;34(5):347-356.   Published online September 26, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.5.347
Background

Pain is the most common but severe physical symptom among cancer patients. This study aimed to identify correlation between pain and psychological symptoms for terminal cancer patients.

Methods

The total sample consisted of 69 subjects who were recruited through two hospice wards, limited to patients who were mentally alert and had no psychiatric diseases. The subjects were divided into two groups according to the numerical rating scale: the pain-free group, 0 to 3 points; and the pain group, 4 to 10 points. We used the Beck depression inventory (BDI), Beck anxiety inventory (BAI), mini-mental status examination-Korea (MMSE-K), and short form 36 health survey (SF-36). Logistic regression analysis was performed to verify the correlation between pain and other psychosocial disorders.

Results

The mean scores of BDI in the pain-free and pain groups were 25.7 and 31.5; mean BAI scores were 23.4 and 34.7; mean MMSE-K scores were 25.7 and 21.8, respectively. There were no significant differences between the two groups in SF-36 score except scores of body pain. The results of logistic regression analysis adjusted for age, sex, marital status, types of cancer, history of chemotherapy, or radiotherapy showed significant correlation between pain and depression (BDI ≥ 24; odds ratio [OR], 4.199; 95% confidence interval [CI], 1.171 to 15.060), and pain and cognitive impairment (MMSE < 24; OR, 5.495; 95% CI, 1.449 to 20.843); but not between pain and anxiety (BAI ≥ 22; OR, 3.011; 95% CI, 0.907 to 9.997).

Conclusion

Pain significantly affects depression and cognitive impairment among advanced cancer patients in the hospice ward. Accordingly, more aggressive treatment of pain is required to reduce not only physical suffering but also physiological distress.

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  • Does the coexistence of pain and depressive symptoms accelerate cognitive decline?
    Patrícia Silva Tofani, Roberta de Oliveira Máximo, Natália Cochar-Soares, Paula Camila Ramírez, Mariane Marques Luiz, Sara Souza Lima, Thaís Barros Pereira da Silva, Thales Batista de Souza, Letícia Coelho Silveira, Valdete Regina Guandalini, Andrew Stept
    Aging & Mental Health.2025; 29(2): 334.     CrossRef
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    Courtney M. Hicks, Megan A. Dyck, Lynn Martin, Dawn M. Guthrie, Shannon L. Stewart, John P. Hirdes
    Pain Management Nursing.2025;[Epub]     CrossRef
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    Hongyu Zhu, Rongbo Lin, Jianyi Wang, ShuFang Ruan, Tingting Hu, Yan Lei, Xi Ke, Huiyu Luo
    BMJ Open.2024; 14(1): e071417.     CrossRef
  • Worse Depression Profiles Are Associated With Higher Symptom Burden and Poorer Quality of Life in Patients With Gynecologic Cancer
    Alejandra Calvo-Schimmel, Marilyn J. Hammer, Alexi A. Wright, Stephanie V. Blank, Bevin Cohen, Carolyn Harris, Joosun Shin, Yvette Conley, Steven Paul, Bruce Cooper, Jon D. Levine, Christine Miaskowski
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    Yesol Yang, Jeehee Han, Todd B. Monroe, Sue Kim
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    Xueying Zhang, Rui Gao, Changteng Zhang, Hai Chen, Ruiqun Wang, Qi Zhao, Tao Zhu, Chan Chen
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    Pascal Jean-Pierre, Ying Cheng, Raheem J. Paxton
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    Won‐Hyoung Kim, Jae‐Nam Bae, Joohan Lim, Moon‐Hee Lee, Bong‐Jin Hahm, Hyeon Gyu Yi
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    Gebbie Ann Rodriguez Nielsen, Helle Hvilsted Nielsen, Zsolt Laszlo Illés, Parisa Gazerani
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Survey of Conceptions about Cold in a Local Area Workers' Periodic Health Examination.
Sae Ron Shin, Ji Ho Choi, Kyu Jin Joo, Heui Jin Paik
Korean J Fam Med 2010;31(7):512-522.   Published online July 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.7.512
Background
To collect basic data which of conceptions about cold by age, sex, education state, economic state, this survey was carried out in a workers' periodic health examination. Methods: 1,056 workers who are working at the one company were included for this survey from Jun 1 to July 7 2006. We obtained self-reported questionnaire from them. The contents of the questionnaire were the general characteristics of workers, the cause and the management of cold. We analyzed true recognition ratio of conception about cold by age, sex, education state, and economic state. Results: According to sex and economic state, true recognition ratio was not different. According to age, 'Virus', 'Germ', 'Cold weather' were lowest above fifties about the cause of cold. 'Self-limited disease', 'Flu vaccination prevents cold', 'Percussion to chest is helpful to remove sputum', 'Inhaling warm steam is helpful to decrease nasal obstruction', 'Washing hands is helpful to prevent cold', 'Many people crowd in a area are susceptible to cold' were lowest above fifties about the management of cold. According to education state, 'Virus', 'Food' were highest above fifties. Except 'Medicine cures fast', 'Injection therapy cures fast', 'Tonsillectomy prevents cold', the others were highest in the above college education. According to education state by age group, only 'Virus' in the forties and 'Virus, 'Food' in the above fifties were highest. 'Flu vaccination prevents cold' in the twenties, 'Injection therapy cures fast' in the forties, 'Medicine cures fast' and 'Injection therapy cures fast' were lowest in the above college education. Conclusion: Age, education level were significantly related to true recognition ratio of conception about cold. So we had to educate low recognition ratio of conceptions.
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The Association between Height and Cognitive Function in Community Dwelling Old Women.
Moo Young Kim, Ji Won Lee, Jee Aee Im, Duk Chul Lee
Korean J Fam Med 2010;31(2):108-114.   Published online February 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.2.108
Background
There are growing evidences that structural and functional brain reserves may be crucial in cognitive function of late life. In old men, height as an important marker of growth and development, is related to late life cognitive decline or dementia. The purpose of this study is to examine the relationship of height to cognitive function in community dwelling old women. Methods: A total of 150 community dwelling old women who can carry out daily life independently were recruited in this study. We measured height, weight and blood pressure with an automatic device and investigated medical history and behavioral habits. We obtained fasting blood samples for the glucose and lipid profile tests and measured physical performance. The Korean version of Mini Mental State Examination (K-MMSE) was used for the assessment of cognitive function. Results: The acceptable cognition group (K-MMSE score ≥ 24) was taller than the impaired cognition group (K-MMSE score < 24) (mean height 150.9 ± 6.1, 148.0 ± 5.4, respectively, P-value < 0.01). In Pearson correlation analysis, height was positively associated with K-MMSE score (r = 0.342, P < 0.01). Multiple linear regression analysis showed that height independently related to K-MMSE score after adjustment of age, waist circumference, systolic blood pressure, diabetes, hyperlipidemia, alcohol drinking, residential district, education, gait speed ( = 0.102, P = 0.03). Conclusion: Height was independently associated with cognitive function in community dwelling old women. For the evaluation of the relationship between height and cognition in diverse cohorts, many studies will be necessary.

Citations

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  • Is Obesity Associated with Lower Mini Mental Test Scores among Elderly? A Cross Sectional Study
    Nezire İnce, Müjgan Öztürk, Reci Meseri, Halit Tanju Besler
    Journal of the American Nutrition Association.2022; 41(6): 600.     CrossRef
  • The Relationship between Height and Cognitive Function among Community-dwelling Elderly: Hallym Aging Study
    Shan Ai Quan, Jin-Young Jeong, Dong-Hyun Kim
    Epidemiology and Health.2013; 35: e2013002.     CrossRef
  • 2,186 View
  • 16 Download
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Factors Contributing Patients' 'Self Requested Referral' in University Hospital Family Medicine Clinic.
Hyun Jung Choi, Jun Su Kim, Ji Yeon Jung, Ka Young Lee, Tae Jin Park
Korean J Fam Med 2009;30(12):951-961.   Published online December 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.12.951
Background
After the referral system had been established, a tendency of patients who prefer to consult themselves to a specialist with 'self requested referral' is increasing in university hospital family medicine clinics. This study was conducted to know which factors of patients who for the fi rst time visited university hospital family medicine clinic to require medical request for 'self requested referral' to a specialist infl uence 'self requested referral' tendency. Methods: Among 905 patients, 647 agreed to the questionnaire were included in this study. We divided the patients in two, the 'self requested referral' group and the 'general patients' group that does not. Patients completed a four-item, selfadministered questionnaire. Results: 'Self requested referral' group tended to have no experience in family medicine and tended to be negative about the need for family medicine (P < 0.001) The factors that have effect on 'self requested referral' are age, occupation, education, experience of family medicine, and recognition degree of necessity of family medicine. Patients in 20-39 of age, who were white colored, higher education had higher tendency of 'self requested referral' and patients who had no experience in family medicine and lower degree of recognition about the necessity of family medicine had higher tendency of 'self-referral'. Conclusion: It is necessary to fi nd ways to increase satisfaction of patients who have factors that have effect on their 'self requested referral' tendency such as age, occupation, education, experience of family medicine, and degree of recognition about the necessity of family medicine.
  • 1,987 View
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Recognition of Family Practitioners on Cold Hands/Feet Syndrome and Raynaud's Disease.
Chul Min Kim, Seon Myoung Ock, Ju Hye Chung, Hong Seok Jang, Dong Jin Yoo, Jung Bok Lee, Whan Seok Choi
J Korean Acad Fam Med 2007;28(5):339-345.   Published online May 10, 2007
Background
Many patients with "cold hands/feet syndrome" have been taking herbal medicine or medicine to improve blood circulation without proven evidence. Raynaud's disease had been neglected in primary care. This study was conducted to investigate the recognition for Raynaud's disease and "cold hands/feet syndrome" by family doctors. Methods: A questionnaire was posted to 905 family doctors who were in practice from January to July 2003. Results: Among the 274 respondents, 58 (21%) reported that they have seen patients with "sensitive to cold" frequently and 208 (76%) doctors have seen such patients sometimes. Only 8 (3%) doctors answered that they have never seen patients with such symptoms. When such patients see a doctor and complain of "cold hands/feet syndrome", most doctors (60%) prescribed medicine that improved blood circulation (83%) or calcium channel blockers (9%). In case of questions like 'Do you suspect "cold hands/feet syndrome" or "sensitive to cold" contain Raynaud's disease?', 132 (48%) doctors answered 'yes'. And among the 132 doctors, only 15 (11.2%) doctors thought that those patients with "cold hands/feet syndrome" had Raynaud's disease. In addition when the doctors diagnosed the condition as Raynaud's disease, 54% prescribed medicine that improved blood circulation (52%) or calcium channel blockers (40%). Conclusion: Most doctors prescribe medicine that improves blood circulation for cold hands/feet syndrome. Many doctors also prescribe medicine to improve blood circulation for Raynaud's disease frequently. The result of our study suggests that there is a need to train doctors so that recognized and diagnosed Raynaud's disease can be correctly. (J Korean Acad Fam Med 2007;28:339-345)
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Factors associated with Receiving Rescreening in High Risk Group Diagnosed by Endoscopic Screening of Stomach Cancer.
Rae Hwan Lee, Ho Cheul Yun, Hee Gyung Joe, Kyong Rae Kim, Joon Ho Wang, Hyuk Jung Kweon, Dong Yung Cho
J Korean Acad Fam Med 2006;27(4):270-277.   Published online April 10, 2006
Background
: Stomach cancer is the most common cancer in Korea. Lifelong health management program recommends that males over 40 years and women over 50 years should undergo stomach cancer screening by endoscopy or upper gastrointestinal series every two years. The importance of re-screening of stomach cancer in a high risk group is emphasized.

Methods : A telephone questionnaire was done one year after to 123 patients over 40 years old considered as a high risk group with either chronic atropic gastritis, intestinal metaplasia, gastric ulcer, gastric adenoma among 804 subjects who had undergone an endoscopic examination from February 2002 to June 2003 at a university hospital health promotion center.

Results : The number of patients who responded were 109. The average recognition rate of high risk group was 53.2%. The rate of recognition of high risk group was lower in good subjective health estimation group and in less educated group, in old age group, and in chronic atrophic gastritis and intestinal metaplasia group. The rate of not receiving re-screening after 1 year was 48 (44.0%). Re-screening rate in patients with intestinal metaplasia (35.3%) and chronic atropic gastritis (39.1%) compared to gastric ulcer (77.8%) and gastric polyp (90.0%), in those not recognizing themselves as high risk group, in low education group, in old age, was lower.

Conclusion : In patients with chronic atropic gastritis and intestinal metaplasia, in those not recognizing themselves as high risk group, in old age and in good subjective health state. We need to educate the importance for regular screening of stomach cancer more intensively.
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How Many Diabetes Patients Know the Name of Hypoglycemic Agents They Are Taking?.
Oh Byung Kwon, Jong Ho Yu, Kyoung Kon Kim, Hee Cheol Kang, Bang Bu Youn
J Korean Acad Fam Med 2005;26(8):456-463.   Published online August 10, 2005
Background
: Numerous diabetes patients do not know the name of hypoglycemic agents that they are taking, even though they have taken them for a long time. The aim of this study was to find out the percentage of diabetes patients who recognize the name of their hypoglycemic agents and to clarify whether such recognition have effect on their glycemic control.

Methods : A cross-sectional questionnaire survey was done from March to May 2004, targeting inpatients and outpatients who had been taking oral hypoglycemic agents for diabetes treatment in 2 hospitals.

Results : 134 patients (89.3%) of 150 completed the questionnaire. Only 20 (14.9%) patients accurately knew the name of at least one of the hypoglycemic agents they were taking. Smoking (P=0.0086), recognition of the name of hypoglycemic agents (P<0.0001), history of change of prescribed hypoglycemic agents (P=0.0095), diet and exercise (P<0.0001), explanation of hypoglycemic agents (P=0.0231), and forgetting to take medicine (P<0.0001) were significantly related to the HbA1c level. Among these factors, history of change of prescribed hypoglycemic agents (P=0.0006), diet and exercise (P=0.0002), and forgetting to take medicine (P<0.0001) were the independent related factors after adjustment.

Conclusion : The recognition rate of the name of hypoglycemic agents was low. It may be associated with patients' HbA1c, but was not an independent related factor.
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Recognition of Osteoporosis and Analysis of Influencing Factors.
Jin Ho Park, Hee Gyung Joe, Ju Young Kim, Tae Yoon Kim, Jung Sun Kim, Jung Ah Lee
J Korean Acad Fam Med 2004;25(7):542-549.   Published online July 10, 2004
Background
: As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analysed the relating factors.

Methods : We made a survey in a rural area called Chunjunlee in Chunchon city. The questionnaire contained general characteristics of people, sociocultural factors, questions constructed to know the recognition of osteoporosis and factors that were presumed to influence people's recognition of osteoporosis. DEXA was performed on those who visited our medical office free of charge.

Results : The total number of people who responded to the questionnaire was 204. They were composed of 81 men and 123 women. Among the total, 83% of women and 72.8% of men said that they had heard about osteoporosis. There was no significant recognition score difference between men and women. In the items of recognition, wrong answer rate concerning the association between osteoporosis and musculoskeletal disorders such as osteoarthritis and low back pain was above 90%. The significant factors that influenced its recognition were age, education level, menopause state and newspaper/ magazine subscription. All men who were diagnosed with osteoporosis on DEXA initially said that they did not have osteoporosis.

Conclusion : Many people had a conceptual confusion between osteoporosis and other muscular skeletal disorders such as osteoarthritis and low back pain. Physicians played no significant role in improvement of people's recognition of osteoporosis. Generally, men thought that osteoporosis was a problem in women only.
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A Study of Treatment Realities and Recognition of Male Osteoporosis.
Young Suk No, Tae Hwan Kwak, Soo Hyoun Chang
J Korean Acad Fam Med 2004;25(7):527-533.   Published online July 10, 2004
Background
: Osteoporosis has been thought of as a disease of women, but the incidence of male osteoporosis is increasing and is expected to keep rising due to alcohol abuse, smoking and increased life expectancy for men. This study was done to evaluate how many men recognized the significance of osteoporosis and its management.

Methods : There were 138 male subjects who underwent Bone Mineral Density (DEXA) from January 2000 to August 2003 at Sung Nam Central Hospital. We reviewed their BMD results and formed questionnaires which were constructed to evaluate men's recognition and treatment realities of osteoporosis. Telephone interviews and mailing services were utilized. The respondents were 96 (69.6%) and analysis was done.

Results : The average age of the 138 men was 55. Among them, there were 55 (39.9%) and 68 (49.3%) men who had been diagnosed with osteopenia and osteoporosis, respectively. Information on osteoporosis was obtained mainly from mass media like TV and newspaper (57.3% of total answers). The reason for undergoing test for osteoporosis was related to the annual screening tests (40.6% of total answers). Most of these people were likely to ignore the significance of osteoporosis, because only 26 percent answered they should receive proper treatment in case of osteoporosis although they did not have any symptoms at the time of the diagnosis. Among these osteoporotic patients, 76.7 percent did not seek any medical care and the most common reason for refusal to treatment was no existing symptoms for osteoporosis. Among the total, 67.4 percent of the patients said there had been no change of life behavior after the diagnosis.

Conclusion : We found that men had relatively more knowledge of osteoporosis than we expected, but they knew little about the need for treatment and possible severe complications like major fractures that may occur. Also, we found the diagnosis of osteoporosis has little effect on behavioral changes. In conclusion, family physicians should take more interest in the education of patients to increase compliance for its treatment.
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How Many Hypertensive Patients Recognize the Name of Antihypertensive Drug That They Are Taking?.
Seung Yeon Lee, Seon Ho Min, Hong Jun Cho, Hong Geou Lee
J Korean Acad Fam Med 2003;24(5):437-443.   Published online May 10, 2003
Background
: Doctor shopping is common in Korea. Therefore, if patients are not familiar with the name of the antihypertensive drug they are taking, they may end up taking a drug that previously caused them side effects and may have to start on a new antihypertensive drug. This study was to clarify the factors related to patients' recognition of the name of their antihypertensive medications.

Methods : A questionnaire survey was done in June 2002 targeting 607 outpatients who were on antihypertensive medication seeking care at Asan Medical Center, Ulsan University Hospital and a clinic in Gyungju. Out of the 607 patients, 293 patients responded to the questionnaire.

Results : Ninety six of the 293 patients (32.8%) were able to accurately name at least one of the antihypertensive drugs they were taking. Women were more familiar with names of antihypertensive drugs than men (39.4% vs 23.6%, odds ratio [O.R], 2.69; 95% confidence interval [CI], 1.39∼5.22). The recognition of a drug was greater in subjects who had a higher education level (high school or university) compared to those with a lower education level (elementary school or less) by 4.2 fold (O.R, 4.20; CI, 1.64∼10.69). The type of concomitant drug intake was lower in subjects who could name their antihypertensive drugs than for subjects who could not (O.R, 0.78; CI, 0.63∼0.98). The patients who could name their antihypertensive drugs had both a lower mean systolic (133.2±11.6 mmHg: mean±standard deviation [S.D] vs 141.3±15.5 mmHg: mean±S.D) and diastolic blood pressure, compared to the patients who could not (84.5±7.2 mmHg: mean±S.D vs 86.8±9.5 mmHg: mean±S.D) when measured twice consecutively during a recent clinic visit.

Conclusion : The recognition of a medication was associated with patient's sex, education level and the number of concomitant drug intake. The patients, who could name the antihypertensive drugs they were taking, had a lower mean systolic and diastolic blood pressure.
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The effect of Tai Chi(9 basic forms) on the equilibrium in the aged: a controlled trial.
Chang Won Won, Byung Sung Kim, Hyun Rim Choi
J Korean Acad Fam Med 2001;22(5):664-673.   Published online May 1, 2001
Background
: Accidental fall is a major risk factor of hip fractures in the aged. Recently Tai chi exercise is reported to reduce the frequency of falls in the American elderly. This study was to evaluate the effects of Tai Chi exercise on equilibrium in the Koreas elderly.

Methods : we selected 4 clubs for the elderly in the same district. The elderly(11 men, 9 women) who attended two of the clubs were offered Tai Chi(9 basic forms) exercise and the elderly(4 men , 21 women) who attended the other two of them were offered regular medical examination. Intervention length was 12 weeks, with outcomes measured before and after intervention.

Results : In men, single left leg standing with eyes open improved in Tai chi group as compared with non-Tai chi group(p=0.026). In women, single right leg standing with eyes open improved in Tai Chi group as compared with non-Tai Chi group(p=0.023), and single left leg standing with eyes open showed improvement in Tai Chi group as compared with non-Tai Chi group(p=0.085). MMSE-K showed improvement in Tai Chi group as compared with non-Tai Chi group, but it was not significant(p>0.05). Those who said these 9 basic forms were not difficult were 81.8% in men, 77.8% in women.

Conclusion : '9 basic forms of Tai Chi' is easy to practice and helpful for equilibrium in the aged. The effect of 9 basic forms of Tai Chi on cognition of the aged needs further studies.
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The recognition and management of obesity at primary care in urban area.
Young Jin Jeoung, Young Ju Yoon, Hye Soon Park
J Korean Acad Fam Med 1999;20(7):886-893.   Published online July 1, 1999
Background
: Recently, the prevalence of obesity has increased due to the development of industries and westernized diet pattern. Also, chronic diseases associated with obesity have increased as well. Although management of obese patients is important in health promotion program, there is no data that support recognition and management of the obesity in primary care. Therefore, surveys concerning such issues were done among internists and family physicians in Seoul.

Methods : In 1997 May, questionnaire was sent by mail to each 887 internists and family physicians working in primary care in Seoul.

Results : A total of 186 replied to the questionnaire consisting of 21% of the total. The proportion of respondents who replied that obesity is a problem for management was 66.3%. Diet control and exercise was recognized as the most effective treatment method 82.1% of respondents recognized that failure to control weight was due to patients themselves. Personal experience in managing obesity patients using informational sources was only 14.5%. The proportion of respondents replied that those whose weight and height were measured for all first-visit patients was 50%, that obese patients received care in was 71%. Behavior modifications, diet control, and exercise were widely recommended, but drug therapy was not. 73.6% of respondents simple explained to control weight to obese patients, but only 17.1% continuously evaluated and managed them.

Conclusion : The degree of recognitions for obesity by primary care physicians in urban area was relatively low, regardless of its importance in health promotion. And, screening for obesity and continuous management for obese patients was inadequate. Efforts to manage obesity patients adequately in primary care is necessary.
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Smoking status of among students two colleges and their familial influence on the continuation of smoking.
Chang Geun Jeong, Yun Ji Lee, Young Sun Kim, Ki Heum Park, Nak Jin Sung
J Korean Acad Fam Med 1999;20(4):358-367.   Published online April 1, 1999
Background
: Current research indicates that smoking among young adults tends to persist into later life. Furthermore, numerous studies have proven the harmful effects of female smoking on their offspring. These trends have produced a wide variety of(social, medical and economic) problems. This study is aimed at obtaining basic information to help prevent potential smokers from trying their first cigarette as well as to instruct to stop smoking. This study involves the following:1) investigating general factors affecting the smoking status of college students in addition to the deterents to smoking b) seeking to understand the familial influence on smoking status c) researching how smokers, exsmokers and nonsmokers perceive their familial influence on their smoking status.

Methods : In June 1998, a self-administered questionnaire was distributed to 800 students of two junior colleges by random sampling in Po'hang. 720 were returned and 642 displayed adequate responses. The questionnaires were analyzed using SPSS and EXCEL software.

Results : Among the total of 642 subjects studied, 220 were males(34.3%) and 422 females(65.7%). Of the male subjects 149(67%) were smokers, 64(21%) were ex-smokers and 25(11.3%) were non-smokers. Of the female subjects 22(5.2%) were smokers, 399(92.9%) were ex-smokers and 11(2.6%) were non-smokers. The number of cigarettes smoked per day was as follows:79 subjects(46.2%) smoked 10-20 cigarettes, 55(33.2%) smoked less than 10 and 37(21.6%) smoked more than a pack of cigarette. When considering the related factors which affect student smoking, it is evident that there is a growing tendency toward smoking among male students when they have close friends who are smokers and who consume alcohol on a weekly basis. About the motives of smoking, there was a significant difference between the following two cases. Those(36.2%) who successfully quit smoking had started to smoke through solicitation by friends, but only 2.7% were successful if they had started to smoke to relieve stress. When it comes to the influence of familial factors on successful versus unsuccessful attempts to quit smoking, the status of family smokers, whether or not smokers made their habit obvious to family members an whether or not the family allowed smoking did not have any noticeable statistical difference between continuation of smoking and smoking cessation. However there was an obvious difference among ex-smokers, non-smokers and smokers when they responded as to whether or not their family had an effect on smoking status and smoking cessation: ex-smokers(38.4%), non-smokers(30.6%) and smokers(17.0%).

Conclusion : In the light of the related factors attributed to the continuation of smoking in this study, it was revealed that there was a higher possibility of current smoking when the subjects were a male and have close friends who smoked and had a higher of average alcohol consumption. This study also indicated that the continued smoking rate was higher among individuals who started smoking because of stress than those who began smoking as a result of peer pressure. There was no significant relationship between smoking status and familial influence on smoking cessation between smokers an ex-smokers, but ex-smokers and non-smokers had more awarness of familial influence than smokers.
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Cognition and performance rate for adult immunization among urban general population.
Seon Ho Ko, Yu Mi Song, Jai Jun Byeon
J Korean Acad Fam Med 1998;19(10):870-880.   Published online October 1, 1998
Background
: Although adult immunization is as important as childhood immunization, is being inadequately performed. However, previous studies concerning adult immunization could not be sufficiently evaluated because studies were restricted to the residents in rural area or those who have visited a doctor.

Methods : We conducted a study by telephone interview which included 201 households(375 adult family members)selected by systematic sampling from the yellow pages of Kangnam-gu and Sungbuk-gu districts of Seoul. The types of immunization covered in this study were immunizations against hepatitis B, influenza, pneumococcus, and hemorrhagic fever with renal syndrome(HFRS). Immunization status of all adult household members, cognition of the need for immunization and of interviewees were surveyed. Sex, age, area of residency, education, medical history of study subjects were considered as factors related to the cognition of the need for immunization and immunization performance.

Results : The cognition rates of immunization were as follows : hepatitis B 85.1%, influenza 45.8%, pneumonia 38.3%, and HFRS 33.8%. In the people over 65 years old, the cognition rate against influenza and pneumococcus were 6.25%, 6.25% respectively and for those who have chronic disease. 80.0%, 20.0%, respectively. The cognition rates of immunization was significantly higher among those subjects who were young, well educated, and those residing in Kangnam-gu district.
The immunization performance rate of hepatitis B was 62.5%, influenza 5.6%, pneumonia 0.8%, and HFRS 1.1%. 75.8% of subjects vaccinated against hepatitis B had received at least three times. The immunization performance rate of influenza and pneumococcus by the immunization indication are as follows : 8.0%, 0.0%, respectively in the subjects over 65 years old, and 11.1%, 0.0% respectively in the people who have chronic diseases. The immunization performance rate of hepatitis B was higher among young, well educated subjects living in Kangnam-gu district. But age, education, area of residency played no apparent role in the case of other types of immunization.
The immunization performance rate of those who felt the need for immunization as significantly higher than that of those who did not. To assess the factors which relate to the correct cognition for immunization necessity, we used a multiple logistic regression test. For all types of immunization surveyed, sex(females) and age(young) seemed to be significantly related to the correct necessity cognition. Medical history of chronic disease was also related to the correct necessity cognition for immunization against hepatitis B and influenza.

Conclusion : This study reveals that among living in urban area the immunization performance rate and the correct cognition rate concerning the necessity for adult immunization was generally very low. Therefore, an active publicity and public education will be needed to increase the level of correct necessity cognition for immunization in which the disease status, sex, and age of vaccinee are considered. And more active effort to increase the cognition for immunization necessity performance is required.
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