• Title/Summary/Keyword: Geriatric disease

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노인들의 사회적 지지와 건강행태 및 건강수준과의 관련성 (The Relations of Social Support to the Health Behaviors and Health Status in the Elderly)

  • 김태면;이석구;전소연
    • 보건교육건강증진학회지
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    • 제23권3호
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    • pp.99-119
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    • 2006
  • Objectives: This study intends to understand the difference within group of social support level and the effect of social support to health behaviors and health status of the elderly by selecting the old of local society as target. Methods: Data were obtained from self-administered questionnaire of 8,688 persons, older than 65 years, living in a community. We measured the sociodemographic characteristics, social support(family support, other support, quality of support), physical health state(subjective health status, number of chronic disease), physical function state(activities of daily living; ADL, instrumental activities of daily living; IADL), cognition state(mini-mental state examination-Korean; MMSE-K) and depression state(short form of geriatric depression scale; SGDS), health behaviors(smoking, drinking, exercise, eating habit). Univariate, multinominal logistic regression and covariance structure analysis were employed to analyze factors affecting on the social support of the elderly. Results: When considering the degree of social support by the sociodemographic characteristics of the older adults, the family support, other support and quality of support is better when the old is male, young, high education and self-reported living status is good and it has significance statistically. When considering the relation between social support and health status, the family support, other support and quality of support is better when the old's subjective and objective physical health status is good. The family support, other support and quality of support is better when the old's subjective health status is better. The other support and quality of support is better when the old's ADL(activities of daily living) and IADL(instrumental activities of daily living) are good. The family support, other support and quality of support is better when the old's cognitive function and depression state is better. When considering the relation between social support and health behaviors, in case of smoking and drinking, the quality of support, family support and other support is better when the old smokes and drinks rather than the old does not. In case of exercise and eating habit, the family support, other support and quality of support is better when the old exercises and eats regularly rather than the old does not. It has significance statistically. From the result of performing covariance structure analysis by structural equation modeling(SEM) with two endogenous variable(health behaviors and health status) and one exogenous variable(social support), factor loading of health status is 0.74 and factor loading of health behaviors is 0.05. The social support explains health status of 55.4% and health behaviors of 2.9%. Conclusions: This study has the meaning that it finds the difference of social support generating from inside of the group for the old residing in city and country and specifies the effect that the difference of social support influences to health status and health behaviors. From now on, in the development of health improvement strategy of the olds, it is necessary to approach from inclusive aspect while considering psychosocial factor such as social support and social economical factor as well as health status.

해녀 우울장애 환자의 임상적 특징 (Clinical Characteristics of Haenyeo with Depressive Disorders)

  • 박준혁;전병선;이창인;김문두;정지운;정영은
    • 생물정신의학
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    • 제23권2호
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    • pp.63-68
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    • 2016
  • Objectives Haenyeo are Korean professional women breath-hold divers in Jeju island. The aim of this study was to investigate the clinical characteristics of depressed Haenyeo group, compared to non-Haenyeo depressed group. Methods This study included 75 Haenyeo and 340 non-Haenyeo with depressive disorders recruited from the Dementia Early Detection Program in Jeju island. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview. All patients completed the questionnaires, including the Subjective Memory Complaints Questionnaire (SMCQ), the Patient Health Questionnaire-15 (PHQ-15), and the Blessed dementia scale. Depression was evaluated by the Korean version of short form the Geriatric Depression Scale (K-SGDS) and cognition was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment packet. Results Although the mean scores of the K-SGDS were similar between Haenyeo and non-Haenyeo depressed groups, the Haenyeo group showed a higher mean score on the PSQ-15 (p < 0.001, ANCOVA adjusting for age, the K-SGDS and education). The Haenyeo group showed poorer performance on the Korean Version of Frontal Assessment Batter (p < 0.001), the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (p < 0.018), the word fluency test (p < 0.001), and the word list memory test (p = 0.012) in ANCOVA adjusting for age and education. The mean SMCQ score was higher in the Haenyeo depressed group than in the non-Haenyeo depressed group. Conclusions The Haenyeo depressed group shows cognitive dysfunction, especially frontal lobe dysfunction, compared to the non-Haenyeo depressed group, indicating the Haenyeo depressed group may have more severe frontolimbic dysfunction due to chronic exposure to hypoxia. The Haenyeo depressed group suffers more somatic symptoms than the non-Haenyeo depressed group.

국내 일부 재가 노인의 식욕부진 실태와 관련 인자 분석 (Appetite and Related Factors among Community Elders in Korea)

  • 박수진
    • 한국식품영양과학회지
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    • 제43권9호
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    • pp.1431-1438
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    • 2014
  • 본 연구는 국내 노인의 삶의 질과 영양개선 및 건강을 증진시킬 수 있는 기초자료를 얻고자 실시된 단면연구로서 재가 노인의 식욕부진 유병 상태를 조사하고, 식욕부진과 관련된 사회 인구학적 특성, 병리적 특성과 심리 특성 및 일상생활 수행능력 등을 조사하였다. 자료 수집은 서울, 경기, 충북 지역의 65세 이상 재가 노인 419명을 대상으로 2012년 9월에서 12월까지 구조화된 설문지를 이용하여 일대일 면접방법으로 수행하였다. 연구 결과 국내 노인의 식욕부진 유병률은 전체 응답자 가운데 35.1%였고, 특히 남성노인의 식욕부진 유병률이 여성노인보다 유의하게 높았다. 남성노인의 식욕부진은 중추신경계 질환을 진단받은 경우가 가장 많았고 여성노인의 경우 식욕부진은 내분비 질환이 있는 경우가 가장 많았다. 또한 우울증 증상이 있거나 일상생활에서 의존도가 높은 경우 식욕부진이 현저한 것으로 관찰되었다. 이상의 결과로부터 국내 재가 노인들의 식욕부진이 심각한 수준임을 알 수 있었고, 노인의 식욕부진은 생리적 특성과 병리적 특성은 물론 우울과 같은 심리적 특성과도 깊은 상관성이 있음을 알 수 있었다. 향후 노인의 식욕부진 개선이나 예방을 위하여 구체적인 영양중재와 영양치료가 필요하며, 노인인구 증가에 따라 노인의 식욕증진을 고려한 노인식품 개발이 시급히 필요할 것으로 생각된다. 본 연구 결과는 다음과 같은 제한점을 갖는다. 본 조사는 단면연구이므로 연구 결과에서 나타난 식욕 수준에 관련된 인자들이 노인의 식욕부진 원인으로 작용했는지는 알 수 없다. 따라서 추후 보다 대표성을 갖는 한국 노인을 대상으로 노인의 식욕부진 유병률의 조사는 물론 식욕부진과 관련된 원인 규명을 위하여 횡단연구가 필요하다. 또한 노인을 일대일 대면하여 자가보고 하는 방법으로 자료를 수집하였으므로 문항에 따라서는 노인에 따라 사실보다 과장하거나 축소하는 등 응답 수준이 주관적일 수도 있다. 그럼에도 불구하고 본 연구에서 나타난 식욕부진과 관련된 인자들은 선행 연구와 유사하며 따라서 자가보고에 의한 사회적 기대 효과는 다소 적었다고 판단된다. 향후 재가노인의 범위를 성별, 연령별, 지역별, 거주형태별 등으로 일치시키고 확대하여 노인의 식욕부진 실태와 관련 인자 연구의 확대를 제안한다.

노년기 우울증 환자의 하지불안증후군의 임상적 중요성 (Clinical Significance of Restless Legs Syndrome in Patients with Late Life Depression)

  • 송재민;박준혁;강지언;이창인
    • 생물정신의학
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    • 제21권3호
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    • pp.107-113
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    • 2014
  • Objectives Restless legs syndrome (RLS) is a sleep disorder characterized by uncomfortable and unpleasant sensations in the legs and an urge to move the legs, usually at night. The aim of this study is to investigate the incidence of RLS in patients with late life depression and its influence on various clinical outcomes such as severity of depression, sleep quality, cognitive function, and quality of life and accordingly, to elucidate the clinical significance of RLS in patients with late life depression (LLD). Methods This study enlisted 170 depressive patients aged 65 years or older from an outpatient clinic. Structured diagnostic interviews were performed using the Korean version of the Mini-International Neuropsychiatric Interview. All patients completed the questionnaires, including the International RLS Severity Scale, the Korean version of Short-Form 36-Item Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). The severity of depression was evaluated by the Korean form of the Geriatric Depression Scale (KGDS) and the level of global cognition was assessed by the Mini-Mental State Examination in the Korean version of The Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (MMSE-KC). Results The incidence of RLS was 17.6% in LLD patients. RLS was more prevalent among the subjects with major depressive disorder (MDD) than those with minor depressive disorder or subsyndromal depressive disorder. The RLS group showed higher score in the KGDS than the Non-RLS group but the difference did not reach the statistical significance (p = 0.095, Student t-test). The mean PSQI score was significantly higher in the RLS group than in the Non-RLS group (p = 0.001, Student t-test). The MMSE-KC score was also lower in the RLS group than in Non-RLS group (p = 0.009, analysis of covariance). But, there was no difference in the score of SF-36 between the RLS group and the Non-RLS group. Conclusions RLS is common in LLD patients, especially in the patients with MDD and is associated with poor sleep quality and cognitive dysfunction, indicating that RLS is clinically significant in patients with LLD. Therefore, RLS should be considered as an important clinical issue in the management of LLD.

치매 환자의 일상생활활동 능력향상에 적용된 작업치료 중재에 관한 체계적 고찰 (Systematic Review about Occupational Therapy Interventions Applied to the Improvement of Activities of Daily Living in Dementia Patients)

  • 곽성원;나현준;강신욱;남주현
    • 한국임상보건과학회지
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    • 제2권1호
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    • pp.35-45
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    • 2014
  • Purpose: This study analyzes occupational therapy interventions to improve activities of daily living (ADL) in dementia patients and the instruments used to verify their effects through a systematic review and attempts to use the results as preliminary data in selecting further interventions and instruments. Method: The databases searched included NDSL, DBpia, RISS, KISS and National Assembly Library with search words including 'Alzheimer's disease', 'Alzheimer', 'daily living' and 'ADL.' The subjects of analysis were a total of 7 studies, and a frequency analysis was used for the usage count of the interventions used in each study. In order to provide evidence, PICO Method was used for sorting. Result: As a result of this study, there were 7 occupational therapy interventions applied to improve ADL in dementia patients, which were used 7 times total. As for the instruments used to validate the effects of the interventions for the ADL, it turned out that '3 studies used AMPS (42.9%),' which was the most, followed by 'Allen Cognitive Level Screen' (ACLS) and Functional Independence Measure' (FIM), respectively used in 2 studies (28.6%); and 'Modified Barthel Index' (MBI) and 'Philadelphia Geriatric Center IADL' (PGC IADL), respectively used in 1 study. Regarding the qualitative level of evidence, it turned out that 4 studies were Level III (57.1%), followed by 2 studies at Level IV (28.6%) and 1 study at Level I (14.3%). Conclusion: This study suggested the kinds and frequencies of usage of the interventions and instruments of occupational therapy for the improvement of ADL in dementia patients, and the studies of evidence were presented by the PICO Method. It is judged that the results of this study can be used as preliminary data in selecting interventions and instruments to improve the ADL in dementia patients. In the future, studies should be carried out on the ADL in other areas related to dementia.

융복합적 접근을 통한 여성노인의 여가력, 가족상태에 따른 우울경향성 연구 (A Study on Depressive disposition by Convergence approach of Leisure History and Family situation in Elderly Women)

  • 최혜정;백순기
    • 한국융합학회논문지
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    • 제6권5호
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    • pp.295-302
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    • 2015
  • 본 연구는 노인의 여가력, 가족상태의 융 복합적 접근을 통한 노인의 우울성향을 심층적으로 비교 분석하였다. 본 연구는 65세 이상(평균 73.5세)의 여성노인 20명이 참여하였으며, 대상자의 여가력 분석은 심층면접법으로 총 10문항으로 구성된 구조화된 질문을 통해 여가력을 파악하였으며 가족상태 설문은 가족의 형태, 동거여부 등 총 7문항으로 구성된 설문지를 사용하였다. 우울증 측정은 Geriatric Depression Scrennng; GDS)를 이용하였다. GDS결과에 따라 우울집단과 정상집단을 구분하였으며, 여가력, 가족상태를 통해서 파악한 노인의 우울성향을 비교한 결과는 다음과 같다. 여가력에서 여가의 만족도가 우울만족도에 긍정적 영향을 미쳤으며(F(2,17)=3.989, p<.05), 반면 여가력이 낮거나, 여가동반자가 없는 경우 높은 퇴행적 우울증상을 보였다. 가족상태 중에 본인의 질환 종류에 따라 우울성향에 유의한 영향을 미치는 것으로 분석되었으며(F(3,16)=4.534, p<.05), 그 외 동거유무, 동거인의 건강상태가 우울성향의 평균값의 차이는 높게 나타났다. 결과 노인의 우울 증상은 표현력이 부족하여 우울성향을 쉽게 파악할 수 없으나 오랜 과거력과 주변의 영향을 많이 받는 것으로 나타나 가족의 범주에서 확대하여 지역사회 네트워크와의 관계와 우울에 관한 연구도 필요할 것으로 보인다. 또한, 여가에 있어서도 신체적, 정서적, 사회적 활동의 형태, 활동의 방법, 활동의 정도를 중심으로 한 일회적인 연구가 아니라 종단적 연구를 통해 향후 노인의 여가참여의 질을 높일 수 있는 융복합적 후속연구가 필요할 것으로 사료된다.

The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015)

  • Foscolou, Alexandra;Tyrovolas, Stefanos;Soulis, George;Mariolis, Anargiros;Piscopo, Suzanne;Valacchi, Giuseppe;Anastasiou, Foteini;Lionis, Christos;Zeimbekis, Akis;Tur, Josep-Antoni;Bountziouka, Vassiliki;Tyrovola, Dimitra;Gotsis, Efthimios;Metallinos, George;Matalas, Antonia-Leda;Polychronopoulos, Evangelos;Sidossis, Labros;Panagiotakos, Demosthenes B.
    • Journal of Preventive Medicine and Public Health
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    • 제50권1호
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    • pp.1-9
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    • 2017
  • Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.

한국(韓國)의 전통적(傳統的) 민간요법(民間療法)의 이용실태(利用實態) 조사연구(調査硏究) -성인병(成人病)에 이용(利用)되는 식품(食品)을 중심(中心)으로- (A Study on the Actual Utilization Korean Traditional Remedies -About foods used on geriatric disease-)

  • 이금숙;황춘선
    • 한국식생활문화학회지
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    • 제5권3호
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    • pp.331-347
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    • 1990
  • This study was designed under the purpose to analyze the Korean Traditional Folk Remedies on food, to submit the basic statistical data, and to utilize them by examining how much they know about the Korean Traditional Folk Remedies and also by examining how frequently they used them. The sample was consisted of 312 housewives living in Daegu, Kyungsan city and Kyungsan-eup, the survey was made by use of questionaires from July 15 to August 1 1989. The results are as follows 1. Analysis of Folk Remedical Contents 1) The method of the Folk Remedies used in this area was mainly food, which can be easily found around their house and easy to use, it was possible to apply scientific principles in some cases. 2) The major popular method was shown to feed boiled barley or brown rice which are known as the Folk Remedy for Diabetes. 3) The ANOVA of variable shows the significant influence on each object which age, religion, the level of education, job, monthly income, and the area except family formation. 2. The Frequency of Folk Remedies and additional analysis 1) The most frequently used Folk Remedy was Arterio-sclerosis(1.44), which is followed by the loss of Eyesight(1.40), Hang over(1.28), Couth(1.27), Cold(1.26) etc. 2) In the analysis of Pearson Correlation between frequencies of Folk Remedies used, and demographic variables such as age(p<.05), the monthly income(p<.01), in that area, total number of response items showed a positive correlation. 3. The source to learn about Folk Remedy. 1) It is acknoledged that they are mostly instructed by their forefathers, friends, neighbors, professional textbooks, mass communications, herb doctors, other medical sources or education at school etc. 2) The ANOVA of Variables shows the big differences between each group by age. Based on the above findings, the following suggestions are made ; Most of Korean Traditional Folk Remedies are recognized scientific and reasonable which are based on the scientific research and herb medicine therefore it should be made good use of for our life in good health additionally. I hereby insist that the importance of our Folk Remedies should be reviewed and focused for maintenance our health.

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대학보건소의 현황과 활성화 방안 연구 - 서울시 여자대학을 중심으로 - (Development of Activation Program through the Evaluation of University Health Center - on the women's university in Seoul -)

  • 권수경
    • 한국학교ㆍ지역보건교육학회지
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    • 제2권1호
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    • pp.41-52
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    • 2001
  • The purpose of this research is to plan the activation of university health business through the appraisal of the function and role of university health centers. To be more specific: Firstly, analyze the facility, personnel, health service of the health centers, Secondly, appraise the role and function of the health centers, and Thirdly, consider the activation plans of health centers. The research method taken was the study of surveys conducted and written research materials on 5 women's universities in Seoul. These materials where descriptively analyzed by converting the surveys, facility and usage of health center and current personnel status in to percentage. The major results of the research are as follows: Unlike as stated in each university's additional clause on the number of personnel were working. This lack of specialized personnel resulted into lack of specialized and various services. Medicine for external application were stocked well whereas only simple medicine for internal application were on shelf and were issued only with a doctor's prescription. Universities with a full-time doctor had various available equipments. One university conducting dental treatment was equipped with indirect chest camera, dental X-ray, unit, chair(dental treatment chair) and even supersonic, electrocardiogram were available. In the case of D women's university, the number of beds compared to the number of students was lower than that of the other 3 universities, to the total size of the university was smaller than that of the other 3 universities. Among health prevention and care matters, health consultation was the only matter practised by all universities. Uniquely, there was one university that hosted epidemic prevention business. There are various tests given by each university, with each showing many differences, but some universities did not even conduct these tests. Vaccinations were usually being conducted through commission. All universities provided basic treatment, therefore matters concerning treatment at health centers were being conducted well. Concerning the management of equipment and documents, all the matters were being conducted except one university where instead of a student medical record, they were using a daily record. Because these were women's universities, most of the educations were on women's health. The subjects of these educations included: sex, contraception, prevention and control of tuberculosis, obesity, mouth hygiene, alcohol, geriatric disease, mental health and first-aid. The rate of health center usage is growing. Being women's universities, the service and treatment practised were mostly concerning sex education.

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Central Sarcopenia, Frailty and Comorbidity as Predictor of Surgical Outcome in Elderly Patients with Degenerative Spine Disease

  • Kim, Dong Uk;Park, Hyung Ki;Lee, Gyeoung Hae;Chang, Jae Chil;Park, Hye Ran;Park, Sukh Que;Cho, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • 제64권6호
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    • pp.995-1003
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    • 2021
  • Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.