Associations Among Health Insurance Type, Cardiovascular Risk Factors, and the Risk of Dementia: A Prospective Cohort Study in Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Data Collection
2.2. Baseline Measurements
2.3. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | Categories | Total Sample n = 15,043 | Non-Dementia Group n = 14,548 (96.7%) | Incident Dementia Group n = 495 (3.3%) | Group Comparison | ||||
---|---|---|---|---|---|---|---|---|---|
t or χ2 | p | ||||||||
n (%) or M (SD) | n (%) or M (SD) | n (%) or M (SD) | |||||||
Age (years) | 73.85 | (6.27) | 73.70 | (6.19) | 78.12 | (7.25) | −13.38 | <0.001 | |
Gender | Female | 10,378 | (69.0) | 10,049 | (96.8) | 329 | (3.2) | 1.52 | 0.217 |
Male | 4665 | (31.0) | 4499 | (96.4) | 166 | (3.6) | |||
Education (years) | 0–6 | 9193 | (61.1) | 8837 | (96.1) | 356 | (3.9) | 25.28 | <0.001 |
7–12 | 4418 | (29.4) | 4311 | (97.6) | 107 | (2.4) | |||
≥13 | 1432 | (9.5) | 1400 | (97.8) | 32 | (2.2) | |||
Cohabitation | Living alone | 3632 | (24.1) | 3502 | (96.4) | 130 | (3.6) | 1.25 | 0.263 |
Living with someone | 11,411 | (75.9) | 11,046 | (96.8) | 365 | (3.2) | |||
Type of health insurance | Health insurance beneficiaries | 13,488 | (89.7) | 13,096 | (97.1) | 392 | (2.9) | 60.55 | <0.001 |
Medical Aid beneficiaries | 1555 | (10.3) | 1452 | (93.4) | 103 | (6.6) | |||
Body mass index (kg/m2) | <18.5 | 544 | (3.6) | 518 | (95.2) | 26 | (4.8) | 27.78 | <0.001 |
18.5–23 | 5479 | (36.4) | 5252 | (95.9) | 227 | (4.1) | |||
23–25 | 4045 | (26.9) | 3928 | (97.1) | 117 | (2.9) | |||
≥25 | 4975 | (33.1) | 4850 | (97.5) | 125 | (2.5) | |||
Drinking status | Non-drinker | 12,179 | (81.0) | 11,765 | (96.6) | 414 | (3.4) | 2.38 | 0.123 |
Current drinker | 2864 | (19.0) | 2783 | (97.2) | 81 | (2.8) | |||
Smoking status | Non-smoker | 11,577 | (76.9) | 11,225 | (97.0) | 352 | (3.0) | 10.63 | 0.005 |
Ex-smoker | 2310 | (15.4) | 2219 | (96.1) | 91 | (3.9) | |||
Current smoker | 1156 | (7.7) | 1104 | (95.5) | 52 | (4.5) |
Cardiovascular Risk Factors | Non-Dementia Group (n = 14,548) | Incident Dementia Group (n = 495) | Age-Adjusted p-Value † |
---|---|---|---|
n (%) | n (%) | ||
Cardiovascular risk factors | |||
Comorbid hypertension | 8138 (55.9) | 281 (56.8) | 0.521 |
Comorbid diabetes | 3011 (20.7) | 111 (22.4) | 0.210 |
Comorbid coronary heart diseases | 1439 (9.9) | 51 (10.3) | 0.974 |
Comorbid stroke | 832 (5.7) | 64 (12.9) | <0.001 |
Current smoking | 1104 (7.6) | 52 (10.5) | 0.002 |
Composite cardiovascular disease risk score | |||
0 | 4605 (31.7) | 139 (28.1) | Referent |
1 | 6234 (42.9) | 204 (41.2) | 0.986 |
2 | 2916 (20.0) | 108 (21.8) | 0.284 |
3 | 714 (4.9) | 37 (7.5) | 0.005 |
4 | 79 (0.5) | 7 (1.4) | 0.005 |
5 | 0(0) | 0(0) | NA |
Variables | HR | SE | p | 95% CI | ||
---|---|---|---|---|---|---|
Type of health insurance | Health insurance beneficiaries | Referent | ||||
Medical Aid beneficiaries | 1.77 * | 0.201 | <0.001 | 1.421 | 2.215 | |
Composite cardiovascular disease risk score | 0 | Referent | ||||
1 | 0.98 | 0.109 | 0.834 | 0.785 | 1.216 | |
2 | 1.07 | 0.143 | 0.588 | 0.828 | 1.395 | |
3 | 1.56 * | 0.301 | 0.021 | 1.071 | 2.278 | |
4 | 2.55 * | 1.011 | 0.018 | 1.174 | 5.546 | |
C statistic = 0.702, 95% CI = 0.678 to 0.725, p-value < 0.001 The Harrell C statistics were obtained by using STATA stcox post-estimation command “estat concordance” and 95% CIs were obtained by using “somersd” package in STATA 11.2 |
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Moon, S.-H.; Seo, H.-J.; Lee, D.Y.; Kim, S.M.; Park, J.M. Associations Among Health Insurance Type, Cardiovascular Risk Factors, and the Risk of Dementia: A Prospective Cohort Study in Korea. Int. J. Environ. Res. Public Health 2019, 16, 2616. https://doi.org/10.3390/ijerph16142616
Moon S-H, Seo H-J, Lee DY, Kim SM, Park JM. Associations Among Health Insurance Type, Cardiovascular Risk Factors, and the Risk of Dementia: A Prospective Cohort Study in Korea. International Journal of Environmental Research and Public Health. 2019; 16(14):2616. https://doi.org/10.3390/ijerph16142616
Chicago/Turabian StyleMoon, So-Hyun, Hyun-Ju Seo, Dong Young Lee, Seong Min Kim, and Jeong Min Park. 2019. "Associations Among Health Insurance Type, Cardiovascular Risk Factors, and the Risk of Dementia: A Prospective Cohort Study in Korea" International Journal of Environmental Research and Public Health 16, no. 14: 2616. https://doi.org/10.3390/ijerph16142616