• Title/Summary/Keyword: poor-health elderly

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Socioeconomic Factors Relating to Obesity and Inadequate Nutrient Intake in Women in Low Income Families Residing in Seoul (서울지역 저소득층 여성의 비만 및 영양소 섭취 부족과 관련된 사회경제적 요인)

  • Hwang, Ji-Yun;Ru, Sung-Yeap;Ryu, Han-Kyoung;Park, Hee-Jung;Kim, Wha-Young
    • Journal of Nutrition and Health
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    • v.42 no.2
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    • pp.171-182
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    • 2009
  • This study was performed to investigate socioeconomic factors relating to obesity and inadequate nutrient intake in women in low income families residing in Seoul. The subjects were 125 women (aged 41-87 y) recruited from the local health center for free health examination for low income families. The socioeconomic status such as educational level, income level, and housing condition were poor. For subjects aged less than 65 years, the prevalence of obesity was 44% based on BMI (${\geq}\;25\;kg/m^2$), 48% based on WHR (${\geq}\;0.85$), and 50% based on waist circumference (${\geq}\;80\;cm$) and for those more than 65 years, these were greater and 57%, 81%, and 79%, respectively. The main food sources of daily diet were vegetables, grains, and fruits. Energy and other nutrient intake was not adequate for all subjects and the inadequacy was more profound in the elderly, showing percentages of subjects whose intake was less than EAR were greater than 50% for all nutrients except for iron and below RI were also greater than 50% for all nutrients. The prevalence of obesity and nutrient inadequacy were not associated with socioeconomic status in subjects aged less than 65 years, however, obesity was associated with household income and nutrient inadequacy was related to education (vitamin A) and housing status (protein, phosphate, and iron) in the elderly. After adjustment for ages, in the elderly, OR for obesity (BMI ${\geq}$ 25, OR = 12.601; 95% CI = 2.338-67.911) and central obesity (WC ${\geq}$ 80 cm, OR = 4.778; 95% CI = 1.103-20.696) were greater in subjects who earned less than 500 thousand Won per month than who earned more. For inadequate nutrient intake, the OR for inadequate intake of Vitamin A (OR = 4.555; 95% CI = 1.491-13.914) was greater in subjects with no education than those educated. Subjects without her own house had greater risk for inadequate intake for protein (OR = 3.660; 95% CI = 1.118-11.981), phosphate (OR = 3.428; 95% CI = 1.157-10.158), and iron (OR = 3.765; 95% CI = 1.205-11.766) than subjects possessing her house. In elderly females in low income families, the socioeconomic status was associated with the risk for obesity (income level) and inadequate nutrient intake (education level and housing status). More attention on these groups should be given for prevention of obesity and inadequate nutrient intake.

Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study

  • Choi, Seohee;Min, Jae-Seok;Jeong, Sang-Ho;Yoo, Moon-Won;Son, Young-Gil;Oh, Sung Jin;Kim, Jong-Han;Park, Joong-Min;Hur, Hoon;Jee, Ye Seob;Hwang, Sun-Hwi;Jin, Sung-Ho;Lee, Sang Eok;Lee, Young-Joon;Seo, Kyung Won;Park, Sungsoo;Lee, Chang Min;Kim, Chang Hyun;Jeong, In Ho;Lee, Han Hong;Choi, Sung Il;Lee, Sang-Il;Kim, Chan-Young;Chae, Hyundong;Son, Myoung-Won;Pak, Kyung Ho;Kim, Sungsoo;Lee, Moon-Soo;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.67-77
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    • 2022
  • Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years. Materials and Methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group. Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072-3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550-5.692; P=0.001). Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.

Unplanned Readmission to Intensive Care Unit during the same Hospitalization at a Teaching Hospital (계획에 없던 중환자실 재입실 실태 및 원인)

  • Song, Dong-Hyun;Lee, Sun-Gyo;Kim, Chui-Gyu;Choi, Dong-Ju;Lee, Sang-Il;Park, Su-Kil
    • Quality Improvement in Health Care
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    • v.10 no.1
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    • pp.28-41
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    • 2003
  • Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.

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A Study on the Health Status and Dietary Intake of Rural Elderly Women in Kyeonggi Province (경기도 농촌 지역 여성노인의 건강 및 식생활 실태조사)

  • 이종현;김민선;이연숙;박양자
    • Korean Journal of Rural Living Science
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    • v.5 no.2
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    • pp.135-144
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    • 1994
  • This study was carried out to investigate health status and nutritional status based on dietary intake and food habit of elderly women in rural area of Keyonggi Province. The subject of this study were 133 elderly women aged 60 and over and interviewed with a questionaire. Main result was as follows : 1) Health score based on modified Cornell Medical Index, CMI(45 out of 195 items) was the average $29.1\pm6.8$ and was not significantly different with family size educational level and farmwork participation. In age, 44.0% of the subject in 60~65 years old was low score of CMI(11~25), but 50% of the subject in older than 80 years old was high score(33~44). The subject with disease was 82% and disease of musculoskeletal system was main type. 2) Dietary intake data obtained by a semiquantitative food frequency questionaire showed the average daily intake of energy, protein, Ca, retinol and riboflavin was lower than RDA Daily energy, protein and Ca intake was individually 84%, 67% and 55.1%. It was retinol that was the least sufficient as 49.1% of RDA. 3) The relation between CMI score(divided into three level : low, middle and high) showed low level was significantly different with others according to daily intake of energy, protein, retinol, thiamin, riboflavin and ascorbic acid. The correlation between CMI score and all nutrient intake were highly significant (p<0.001), thus we knew that health status was affected importantly by nutrient intake. 4) Family size, educational level and age showed not significant correlation with all nutrient intake. 5) In food habit, 84.8% of the subject had regular mealtime and 14.4% were skip meal sometimes. The main reason of skip meal was a poor appetite. Preference for salty taste of subject was insufficiently salty of somewhat salty. Preference for fishes and meats showed the subject consumed fishes more than meats, but 23.5% of the subject didn't consume both. The subject eaten supplement was 38.3%.

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A Study on Community-dwelling Elders with Dementia, their Primary Caregiver, and Living Environments (재가 치매노인의 주 수발자와 환경 실태)

  • Kim Nam Cho;Kim Jung Hee;Lim Young Mi
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.13-29
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    • 2002
  • The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

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Analysis of Relationship Between Dental Health Condition and Eating Habit (치아건강상태와 식습관과의 상관관계 분석)

  • kim, Jeong-Sook;Lee, Jong-Do;Jung, Hyo-Kyung
    • Journal of Technologic Dentistry
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    • v.29 no.1
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    • pp.103-119
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    • 2007
  • The survey on dental health condition and eating habit of local residents in Daegu and Kyungbuk had been conducted. Through the analysis of influence of dental health condition on eating habit I could get the following result. The number of subjects of survey is 630. The period of survey is from June 2006 to September 2006. 1. General quality of subjects is that forty-four point four percent of subjects are male and fiftyfive pointsix percent are female. The age of thirty point one percent of subjects is between 20 and 29. Fifty-six point two percent of subjects are married. Fifty-one point four percent of subjects have above bachelor degree. Monthly income of forty-four point eight percent of subjects is less than one million won. Twenty-four point four percent of subjects are students. Fifty-five point seven percent of subjects are living in big cities. 2. Forty-seven point seven percent of male and fifty-one point eight percent of female answered their subjective dental health condition is bad. Marital status, age and academic background have relationship with answer. Forty-three point nine percent of married subjects and forty-one point five percent of divorced or bereaved subjects said they have bad dental health condition. The older he is or the lower academic background he has subjects think they have bad dental health condition. Forty-seven point four percent of non-educated subjects answered their dental health condition is bad. Forty-six percent of self-employed subjects and subjects who live in the country have tendency to think their dental health condition is bad. 3. About eating habit knowledge, male's knowledge of 2.03$\pm$0.20 is lower than female's of 2.08$\pm$0.21. This shows there is statistically significant difference(p<0.01). 4. There is significant relationship between subjective dental health condition and health condition of subjective. This means subject who has better health condition has also better dental health condition(37.5%). About subjective dental health condition, subject who eats restoratives has worse dental health condition. This shows there is a relationship between dental health condition and eating restoratives(p=0.004) and subject who works out steadily has better dental condition. 5. About relation between dental health condition and eating habit, subject who eats vegetables has worse dental health condition by fifty point seven percent. As cross tabulation result, p-value is 0.002. In level of significance of 0.05, there is statistically significant difference in eating habit. 6. It seems that eating habit has an effect on marital status, age, academic background, income and also on dental prosthetic treatment situation. Many subjects think their dental health condition is bad. About eating habit, subjects who eat meat have better dental health condition. Subjects who drink green tea and fruit juice has better dental health condition than who drink coffee and Balanced diet is good for dental health condition. As eating habit is important for developing dental health, government should make a proper program. Dental health education program especially for elderly, low-eduacted, residents in the country and poor people should be developed. Government, dental health organization, dental health specialist, associated research institution and people work in the press should be concerned and devote to improve quality of life. Primary prevention education will help for dental health.

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The Effects of Farming in Greenhouses with Respect to Subjective Fatigue Symptoms (비닐하우스 재배자의 피로자각증상에 관한 연구)

  • Hwang, Gyeong Ae;Lee, Sok Goo
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.2
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    • pp.177-185
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    • 1998
  • The purposes of this study were to investigate the effects of farming in greenhouses with respect to subjective fatigue symptoms among farmers and the degree of symptoms. The study compared 176 green-house farmers with 216 open field farmers using a subjective fatigue symptoms rating scale developed by the Industrial Research Institute of Fatigue, Japanese Association for industrial Hygiene. 1. With respect to complaint rates of the subjective fatigue symptoms, the results indicated that greenhouse farmers have, in order of severity, high degrees of low back pain, difficulty in collecting thoughts, and apt to forget. 2. With respect to cumulative scores of fatigue symptoms, the results indicated that both groups of farmers exhibited a lack of attentiveness and a high degree of dullness and sleepiness(category I), body projection of fatigue(category II), and difficulty in concentration(category III). 3. With respect to general characteristics, it was found that the degrees of subjective fatigue symptoms were found to be higher among females, people with lower educational levels, and the elderly, regardless of the group. 4. With respect to work related factors, farmers with more years of experiences were found to have higher degrees of subjective fatigue symptoms, except for open field farmers with less than nine years experience. Both groups of farmers were found to have high degrees of subjective fatigue symptoms when working less than eight hours a day and less than six months a year. 5. With respect to health habits, for people who get less than eight hours of sleep per day exhibited higher fatigue scores than people who get more than eight hours. People who do not smoke and drink also exhibited higher fatigue scores than people who smoke and drink. 6. The results of multiple regression showed that the risk factors related to the subjective fatigue symptoms of farmers in the greenhouse group were ages, levels of education, sex and for the comparison group, were sex. years of farming, and hours of sleep. The R-square were 12.5% in the greenhouse group and 12.1% in the comparison son group. The differences between the greenhouse and open field farmers in the degrees of fatigue symptoms were found not to be statistically significant even if the working conditions of the greenhouse farmers were poor. This may be attributed to non-work related factors, i.e., social, economical, and psychological factors among greenhouse farmers.

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Trends in Ischemic Heart Disease Mortality in Korea, 1985-2009: An Age-period-cohort Analysis

  • Lee, Hye-Ah;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.5
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    • pp.323-328
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    • 2012
  • Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

The Effect of Postural Stability on Genu Varum in Young Adults

  • Chae, Yun-Won;Park, Ji-Won;Park, Seol
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.419-422
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    • 2012
  • Purpose: Malalignment of the lower limbs may increases the difficulty of maintaining equilibrium. The purpose of this study was to study the effects of genu varum and poor posture in the sagittal plane on postural stability. Methods: We had 27 subjects with varus and 27 normal subjects participate in this study. Subjects for whom the distance between the medial epicondyles in the knee joint was more than 3 cm were classified as varus group, and subjects for whom the distance was less than 3 cm were classified as normal group. The measurements of static and dynamic stability were used overall stability index (OSI), anterioposterior stability index (APSI), and mediolateral stability index (MLSI) using a Biodex balance system. Results: When measuring the static stability index, there were significant differences in the mediolateral stability index between the varus and control groups. When measuring the dynamic stability index, there were significant differences in the overall, anteriorposterior, and mediolateral stability index between the varus and control groups. These results demonstrated that genu varum affects mediolateral movement in static stability, and overall, anterioposterior and mediolateral movements in dynamic stability. Conclusion: As genu varum affects static and dynamic stability in young adults, it increases the risk of injuries or falls. Exercise and surgery are required for realigning the genu varum. Future studies about postural stability in young children and elderly people who have a risk of falls due to lower postural control ability, are needed, as well as in young adults.

Effects of Physical Activity on Glycemic Control in Type 2 Diabetics (제2형 당뇨병 환자의 신체활동이 혈당조절에 미치는 영향)

  • Choi, Eun-Jin
    • Korean Journal of Adult Nursing
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    • v.23 no.3
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    • pp.298-307
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    • 2011
  • Purpose: The purpose of this study was to examine the effects of physical activity on glycemic control among Koreans with type 2 diabetes. Methods: A total of 215 patients with type 2 diabetes (82 male and 133 female) were recruited (mean age = $59.0{\pm}9.7$ years). The amounts of physical activity was assessed using the physical activity scale for elderly (PASE). Fasting blood glucose (FBG), Hemoglobin A1c ($HbA_1c$), and 2 hours post-prandial glucose (2hrPG) were measured. Results: The highest PASE score was housework-related physical activity. However, the amounts of walking was significantly higher in good FBG level (Z = 1.39, p=.041) and the amounts of leisure-time physical activity was higher in good HbA1 and 2hrPG level than in the poor glycemic control group (Z = 2.29, p<.001; Z = 1.99, p=.001). A logistic regression analysis showed that patients with leisure-time physical activity in the top quartile more likely presented with good glycemic control in $HbA_1c$, OR=3.84 (95% Confidence Interval (CI) = 1.65~8.95) and in 2hrPG, OR=4.06 (95%CI = 1.77~9.27), compared to patients in the lowest quartile. Conclusion: Leisure-time physical activity is effective for controlling the glucose levels, especially $HbA_1c$ and 2hrPG among type 2 diabetic patients. It is suggested that health providers need to more focus on providing aggressive recommendations on physical activity considering physical activity patterns by individuals.