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Depression is prevalent in patients with chronic kidney disease (CKD) and continues to increase in elderly adults. Therefore, the aim of our study was to examine the relationship between CKD and depression in older patients.
We conducted a cross-sectional study based on 2013 Korea National Health and Nutrition Examination Survey data. In total, data of 973 subjects aged ≥65 years were analyzed, and the estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation.
The prevalence of depression in older adults was 4.1% in men and 8.8% in women (P=0.004). The prevalence of depression did not differ according to CKD stage in women (normal eGFR and CKD stages 1 and 2 women, 41/474 [8.6%]) vs. CKD stages 3–5 women, 6/63 [9.5%]); however, the prevalence of depression in men with CKD stages 3–5 (8/83 [9.6%]) was significantly higher than in men with normal eGFR and CKD stage 1 and 2 (10/353 [2.8%], P=0.010). Multivariate logistic regression analysis showed that the odds ratio for depression in men with CKD stages 3–5 was 3.822 (95% confidence interval, 1.229 to 11.879) after adjusting for social status and chronic diseases (P=0.021).
The prevalence of depression was higher in elderly women than in men, while the prevalence of depression increased in elderly men with CKD stages 3–5 and was almost equal to that of women. Therefore, elderly men with progressive renal function impairment should be counseled and monitored for psychological problems.
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Vitamin-mineral supplements are the most popular dietary supplements in Korea. However, few studies have assessed the relationship between vitamin-mineral supplementation and associated factors among the Korean elderly. The purpose of this study was to assess the use of vitamin-mineral supplements among elderly in Korea as well as its association with sociodemographic factors, health-related behaviors, medical conditions, and nutrient intake.
This study was based on data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008 to 2009. Data from 3,294 elderly men and women (65 years of age and older) were analyzed. Multivariable-weighted logistic regression model analysis was used to evaluate the association between vitamin-mineral supplement use and sociodemographic factors, health-related habits, and medical conditions.
Vitamin-mineral supplementation was reported by 16.3% of the participants. The most common reason for using dietary supplements was recommendations from friends and acquaintances. Highly educated person, female participants had a greater likelihood of taking vitamin-mineral supplements. In addition, analysis of nutrient intake from food sources alone revealed a lower proportion of vitamin-mineral supplement users with nutrient intakes below the estimated average requirements for vitamin A, vitamin C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus, compared to nonusers. However, vitamin-mineral supplementation was not associated with health-related behaviors or medical conditions.
Highly educated person, elderly Korean women had a greater likelihood of using vitamin-mineral supplements. In addition, nutrient intakes from food sources alone were significantly higher among vitamin-mineral supplement users. Finally, vitamin-mineral supplementation may be an indicator of healthier diet in elderly Koreans.
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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.
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.
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).
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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An association between sleep duration and a wide spectrum of diseases has been reported, but little is known about its relationship with bone mineral density (BMD). Previously conducted studies in Korea and abroad have reported results that are controversial. The present study sought to assess whether sleep duration can be considered an independent risk factor of osteoporosis.
We included participants over the age of 60 years with data on self-reported habitual sleep duration and BMD measured with dual X-ray absorptiometry. Comprehensive data on the study sample was obtained from the Korea National Health and Nutritional Survey performed from 2008 to 2010. Sex-stratified multiple regression analyses were conducted with adjustments for possible confounding factors.
There was a significant inverse dose-dependent association between sleep duration and BMD measured at total hip, femur neck, and lumbar spine for women and total hip and femur neck for men. Sex-stratified regression analyses adjusted for age and body mass index revealed that sleep duration had a negative correlation with BMD at total hip and femoral neck for both women (β = -0.0048; P = 0.0172 for total hip, β = -0.0037; P = 0.0303 for femur neck) and men (β = -0.0057; P = 0.0218 for total hip, β = -0.0057; P = 0.0143 for femur neck). For women, the significance remained after further adjustment of confounding variables.
Prolonged sleep duration appears to have a significant association with lower total hip and femur neck BMD in elderly women but not in elderly men.
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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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Frailty is considered to be a clinical syndrome characterized by decreased physiological reserves associated with a greater risk of health-related problems, hospitalization, and death. The current study examined hospitalization, falls, cognitive decline and disability between robust, prefrail and frail elderly in one year.
110 participants aged 65 or more who visited two senior welfare centers in Seoul from February 2008 to June 2008 were surveyed again from March 2009 to June 2009 with demographic characteristics, number of chronic diseases and medication, study of osteoporotic fractures (SOF) frailty index, instrumental activity of daily living (IADL), depression, mini-mental state examination-Korean version (MMSE-K), falling history and admission history within one year. These results were compared with participants' previous survey done one year ago.
Among total 110 subjects, 48 (44%) robust, 30 (27%) prefrail, and 32 (29%) frail subjects changed to 26 (24%), 54 (49%), and 30 (27%) respectively over the year. There were statistical significances in age, number of chronic disease, depressive mood, MMSE, falls, hospitalization, IADL disability contributing to frailty (P < 0.05). Frailty defined by SOF frailty index was associated with greater risk of adverse outcomes. Frail subjects had a higher age-adjusted risk of cognitive function decline (odds ratio [OR], 3.57), disability (OR, 9.64), fall (OR, 5.42), and hospitalization (OR, 4.45; P < 0.005).
The frailty index like SOF frailty index might predict risk of falls, disability, hospitalization, and cognitive decline in the elderly, emphasizing special attention to the individuals showing frailty in outpatient examination.
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