Search Results (257)

Background/Objectives: South Korea became a super-aged society in 2024, and this demographic shift is unfolding alongside the depopulation of rural municipalities across the country. How spatial inequality and community social capital jointly relate to elderly health—and whether those relationships look different for younger versus older elderly—remains an open question. We investigated associations between two dimensions of community social capital (sense of belonging and neighbor communication), subjective perception of capital–provincial inequality, and self-rated health among Korean elderly, with separate analyses for the Young-Old (aged 60–69) and Old-Old (aged 70+). Methods: We used the 2024 Social Integration Survey from the Korea Institute of Public Administration (full sample N = 2588; elderly subsample N = 1020). Random intercept hierarchical linear models accounted for the nesting of individuals within 17 metropolitan cities and provinces. Stepwise models examined social capital antecedents, a healthcare satisfaction indirect association pathway, and the direct association of spatial inequality perception with health. The elderly subsample was stratified into Young-Old (N = 289) and Old-Old (N = 731). A mixed-effects ordered logistic regression with Liang–Zeger cluster-robust standard errors was estimated as a robustness check. Results: Sense of belonging was positively associated with subjective health among the elderly (B = 0.065, p < 0.05) as a net of rurality and socioeconomic controls. Perceived spatial inequality showed a negative association (B = −0.070, p < 0.05). The indirect association pathway through healthcare satisfaction was not supported (Sobel Z = −1.458, p = 0.144). Age-stratified models revealed a striking split: belonging was the dominant predictor for the Young-Old (B = 0.149, p < 0.01), while neighbor communication (B = 0.078, p < 0.05) and spatial inequality perception (B = −0.092, p < 0.01) were significant only among the Old-Old. The ordered logistic robustness check confirmed the negative association of perceived spatial inequality across all specifications. Conclusions: What predicts health in the younger elderly is not what predicts health in the older elderly. Korea’s Integrated Community Care Act, set for nationwide rollout in 2026, should account for this divergence—prioritizing psychological community attachment for the Young-Old and face-to-face social contact combined with regional equity for the Old-Old. Full article

This study examines the determinants of subjective economic status and life satisfaction among Korean middle-aged individuals, defined as those between 45 and 57 years old. The research explores the impact of eating out expenses, clothing expenses, employment status, and physical exercise on these factors. Data is drawn from the Korean Longitudinal Study of Elderly Employment (KLoEE) for the year 2022, with a sample size of 4392 observations. To test the research hypotheses, quadratic multiple regression analysis was employed. The findings reveal that subjective economic status is significantly influenced by both eating out and clothing expenses, exhibiting an inverted-U-shaped effect. Additionally, an inverted U-shaped relationship between clothing expenses and life satisfaction was also observed. Employment had a positive effect on subjective economic status but a negative impact on life satisfaction. Furthermore, regular physical exercise was found to influence both subjective economic status and life satisfaction positively. The study concludes that subjective economic status positively affects life satisfaction among the Korean middle-aged population. This research contributes to the literature by identifying key behavioral characteristics of this demographic in Korea and discussing relevant policy implications. Full article

Background/Objectives: The Korean Global Antimicrobial Resistance Surveillance System monitors bloodstream Staphylococcus aureus infections by combining antimicrobial susceptibility testing (AST) with conventional polymerase chain reaction (PCR). Considering the clinical significance of methicillin-resistant S. aureus (MRSA), we performed an in-depth analysis of isolates showing genotypic–phenotypic discrepancies. Methods: Isolates were collected from designated collection centers in the Republic of Korea between 2017 and 2024. The 30 μg cefoxitin disk diffusion method was used to define the phenotypes. PCR targeting mecA and the staphylococcal cassette chromosome mec (SCCmec) was used to identify genotypes through gel electrophoresis. Long-read whole-genome sequencing (WGS) was performed using the Revio system (Pacific Biosciences) for isolates exhibiting discrepancies between phenotypes and genotypes. Results: In total, 5808 isolates were screened, and seven cases of genotypic–phenotypic discrepancies were identified, including one infant and six elderly patients with chromosomal SCCmec type IV. Although WGS confirmed intact PCR primer-binding sites, structural alterations were observed: three isolates had normal-length mecA and mecR1, two had partial deletions in mecA, and two featured either mecA or mecR1 split into two proteins. Notably, although the six isolates with intact mecR1 genes matched the nucleotide length of SCCmec type IV, their sequences exhibited high homology with SCCmec type II. Conclusions: Despite the presence of mecA, the non-standard configuration of regulatory genes within the SCCmec elements suppressed actual resistance expression. Because conventional PCR focusing on partial gene segments could overlook such phenotypic traits, the meticulous observation and implementation of WGS are crucial for the accurate characterization of genotypic–phenotypic discrepancies. Full article

Background: The elderly are vulnerable to chronic diseases and altered lipid metabolism, leading to poor outcomes, including mortality. We investigated the association between Korean Medicine (KM) utilization, blood lipid levels, and health outcomes using the National Health Insurance Service Sample Cohort (NHIS-NSC) database. Methods: This retrospective cohort study included elderly participants who underwent health examinations (2009–2010). Participants were divided into KM and non-KM groups and matched 1:1 using propensity score matching (PSM) for age, sex, income, and comorbidities. Primary outcomes were mortality and disease diagnosis; secondary outcomes included medical spending and utilization. Results: After PSM, 13,044 subjects were analyzed. KM utilization was associated with a significantly lower risk of all-cause mortality (HR 0.93; 95% CI 0.87–1.00; p = 0.048). However, the hypolipidemia subgroup showed no significant differences in all-cause mortality and medical expenses compared to other lipid status subgroups. While the KM group showed a higher incidence of disease diagnosis (HR 1.09; 95% CI 1.04–1.14; p < 0.001), this may reflect increased healthcare engagement and proactive health-seeking behavior. Subgroup analysis revealed that statin users in the KM group had a significantly reduced mortality risk (HR 0.91; 95% CI 0.84–0.99; p = 0.022). Medical expenses and utilization were higher in the KM group. Being underweight or aged over 85 was associated with higher mortality. Conclusions: KM utilization is associated with reduced all-cause mortality after propensity score matching, particularly among statin users. Although KM users had a higher cumulative incidence of disease diagnosis, this potentially reflects increased diagnostic opportunities from prolonged survival. Hypolipidemia, underweight, and late-elderly status remain significant risk factors associated with frailty. KM may support improved survival in the elderly, warranting further prospective studies. Full article

Background/Objective: Frailty is a major public health concern among older adults, particularly those living alone who may experience limited social support and increased nutritional vulnerability. With the rapid expansion of digital technologies, electronic device usage has become an important factor influencing daily life and health behaviors in older populations. This study aimed to examine the association between electronic device usage and frailty among older adults living alone and to investigate whether nutrition management mediates this relationship. Methods: This cross-sectional study conducted a secondary analysis using data from the 2023 Korean Elderly Survey. A total of 3423 adults aged ≥ 65 years who were living alone and completed the survey independently were included in the analysis. Descriptive statistics, independent t-tests, one-way analysis of variance, and Pearson correlation analyses were performed using SPSS version 26.0. Mediation analysis was conducted using Model 4 of the PROCESS macro (version 4.1) to examine the mediating role of nutrition management in the relationship between electronic device usage and frailty. Results: Electronic device usage was negatively associated with frailty and positively associated with nutrition management. Frailty was significantly higher among individuals with poorer nutrition management. Mediation analysis indicated that electronic device usage had both a direct effect on frailty and an indirect effect through nutrition management. Nutrition management partially mediated the relationship between electronic device usage and frailty, accounting for approximately 18% of the total effect. Conclusions: Electronic device usage was associated with lower levels of frailty among older adults living alone, and this relationship was partially mediated by nutrition management. These findings suggest that improving digital engagement may support better nutrition management and potentially contribute to frailty prevention among older adults living alone. Future longitudinal studies are needed to clarify the causal relationships among these variables. Full article

Chronic lymphocytic leukemia (CLL) is uncommon in Asia, and longitudinal genomic data from Asian cohorts are limited. We conducted serial whole-exome sequencing (WES) in a multicenter Korean cohort of newly diagnosed, elderly CLL treated with chlorambucil–obinutuzumab to evaluate mutational heterogeneity and clonal hematopoiesis of indeterminate potential (CHIP) during treatment and follow-up. Tumor-only variants were filtered, restricted to nonsynonymous or loss-of-function coding/splice-site mutations, and summarized as a binary patient-by-gene matrix for principal component analysis (PCA), trajectory analysis, and k-means clustering. CHIP was defined as ≥1 qualifying mutation in a prespecified CHIP gene set. Baseline PCA was more compact in patients with complete response at end of treatment, whereas partial response or progressive disease cases were more dispersed. PCA trajectories were compact and directionally consistent in complete responders, more dispersed in partial responders, and highly heterogeneous without a dominant direction in progressive disease. Clustering identified dispersed and compact clusters, and CHIP-associated mutations were enriched in the dispersed cluster (55.6% vs. 8.3%, Fisher’s exact p = 0.0086). In paired samples collected 3–5 months after end of treatment, CHIP status changed in some patients. Serial WES may provide complementary information to treatment response, although these observations require confirmation in larger cohorts. Full article

Background: Sepsis remains a leading cause of mortality worldwide. This study evaluated the independent and combined effects of age and chronic comorbidities on clinical outcomes in patients with septic shock. Methods: We conducted a multicenter retrospective observational study to evaluate the factors associated with 28-day mortality in the Korean Shock Society registry between 2015 and 2023. Adults with suspected infection and refractory hypotension or hypoperfusion within 6 h of emergency department (ED) arrival were included. Patients were grouped by age (<50, 50–74, and ≥75 years) and comorbidity status. Comorbidities encompass major chronic conditions including hypertension, diabetes mellitus, malignancy, history of organ transplant, dementia, nursing home residence, chronic disease of cardiac, lung, liver, and kidney. The primary outcome was 28-day mortality. Multivariable logistic regression analysis was used. Results: Among 8787 patients (median age 70.2 years), the 28-day mortality rate was 22.9% (n = 2018). Elderly patients with comorbidities had the highest mortality (27.5%). Additionally, patients aged over 50 with at least one comorbidity accounted for 18% of the total cohort (n = 1605) but accounted for nearly 80% of all 28-day deaths. Although younger patients without comorbidities represented a small subgroup, their mortality was not negligible (7.3%) and was substantially higher with comorbidities (22.2%). Compared with patients <50 years, adjusted odds ratios (aORs) of 28-day mortality were 1.81 (95% CI, 1.08–3.03) for 50–74 years and 3.21 (95% CI, 1.92–5.37) for ≥75. The presence of any comorbidities was independently associated with higher odds of 28-day mortality compared with no comorbidity (aOR 2.67; 95% CI, 1.57–4.54). A significant interaction between age and comorbidity status (p for interaction = 0.008) suggested that the age-related gradient in mortality differed depending on comorbidity burden. Conclusions: Age and comorbidities were both significantly associated with septic shock mortality, and their significant interaction demonstrates effect modification, indicating that the prognostic impact of comorbidities differs by age group and that age-related mortality gradients are influenced by comorbidity burden. Full article

This study quantitatively analyzed the impact of concurrent large-scale wildfires that occurred in Korea in March 2025 on air quality in agricultural regions and identified potential risks to agricultural workers. Analysis of air quality data from eight agricultural sites nationwide revealed that the average concentrations of PM₁₀ and PM_2.5 during the wildfire period increased by 47.3% and 24.9%, respectively, compared to non-fire periods. Multiple regression analysis indicated that PM₁₀ concentrations were dominated by physical dispersion and dilution effects driven by variables such as wind speed and distance. In contrast, PM_2.5 showed a strong positive correlation with relative humidity, suggesting it is significantly influenced by secondary formation and atmospheric stagnation. Notably, the potential for particulate matter accumulation was confirmed during high-humidity hours when atmospheric inversion layers form, combined with the basin topography characteristic of Korean rural areas. This implies that elderly agricultural workers may be exposed to high concentrations of hazardous substances even when smoke is not visually apparent. Therefore, this study suggests the necessity of establishing specific protective measures for agricultural workers, including the introduction of targeted, site-specific forecasting (“pinpoint forecasts”) for downwind farmlands and restrictions on outdoor work during early morning hours. Full article

Background/Objectives: High-density lipoprotein cholesterol (HDL-C) regulates muscle energy metabolism and function, enhancing glucose uptake and promoting glycogen synthesis. However, studies on the association between HDL-C levels and sarcopenia remain controversial. We therefore investigated the association between HDL-C levels and sarcopenia in elderly Koreans. Methods: This cross-sectional study was based on previously collected, anonymous health checkup data. Participants included 3776 individuals aged 65 years and older who underwent body composition analysis using a bioelectrical impedance meter during a health checkup in 2024. Sarcopenia was defined as an appendicular skeletal muscle index of <7.0 kg/m² for males and <5.7 kg/m² for females. Logistic regression analyses were performed for each variable, including HDL-C levels, to identify sarcopenia association expressed as odds ratios (ORs). Participants were further divided into four quartiles according to HDL-C levels, and comparative multivariable analyses were performed, with the quartile with the lowest HDL-C level serving as the reference. Results: Of the 3776 Koreans with a mean age of 70.5 years, sarcopenia was diagnosed in 23.1% (n = 872) of participants. Sarcopenia prevalence showed a steadily increasing trend from the lowest quartile group (Q1, n = 977) with HDL-C levels ≤48 mg/dL to the highest quartile group (Q4, n = 974) at ≥67 mg/dL (p < 0.001). After adjusting for sarcopenia-associated risk factors, a significant association was found between the condition and HDL-C levels (OR 1.01, 95% CI 1.00–1.02; p = 0.008). Q4 showed a consistent sarcopenia association compared with Q1, even after adjusting for all variables (OR 1.36, 95% CI 1.05–1.75; p = 0.018). Conclusions: In Koreans aged 65 years and older, we found an association between high HDL-C levels and sarcopenia. Full article

Background: The contribution of adiposity and metabolic syndrome (MetS) to thyroid cancer risk in late life, particularly among the elderly, is unclear. Methods: We conducted a nationwide cohort study of Korean adults aged ≥75 years who underwent standardized health screening. Exposures were body mass index (BMI), waist circumference (WC), and MetS defined by standard clinical criteria. The incidence of thyroid cancer was determined using administrative data. Fine–Gray sub-distribution hazard models estimated adjusted hazard ratios (HRs) with prespecified stratification by sex and age (75–84 vs. ≥85 years). Results: Among 1,164,707 participants (60.3% women), 2645 incident cases were identified. In the fully adjusted models, obesity (BMI ≥ 25 kg/m²) was associated with a 37% higher hazard (HR, 1.37; 95% confidence interval [CI], 1.27–1.49) and MetS with an 18% higher hazard (HR, 1.18; 95% CI, 1.09–1.28). In sex-stratified models, MetS was associated with thyroid cancer in women (HR 1.19; 95% CI, 1.08–1.31) and showed a similar direction of association in men (HR 1.16; 95% CI, 1.00–1.35), with overlapping CIs. By age, associations were evident at 75–84 years (MetS: HR, 1.18; obesity: HR, 1.36), whereas at ≥85 years, only obesity remained significant (HR, 1.90; 95% CI, 1.13–3.18). Among MetS components, high WC showed the most consistent association (HR, 1.31; 95% CI, 1.21–1.42). Conclusions: In adults aged ≥75 years, general obesity and, in particular, central adiposity are robustly associated with incident thyroid cancer, whereas metabolic syndrome confers a more modest and mainly age- and sex-specific additional risk. Full article

Background/Objectives: Maintaining independent mobility among older adults requires complex cognitive and physical health and is influenced by various health-related factors. This study sought to examine the relationship between health-related factors and driving among community-dwelling older adults by comparing the health status of currently driving individuals and those who have ceased driving. Methods: A secondary data analysis was conducted using the 2023 Korean Elderly Survey, collected between 4 September and 12 November 2023. A total of 4114 individuals aged 65 years or older were included. Statistical analyses were performed using chi-square tests, independent t-tests, and weighted binary logistic regressions via IBM SPSS for Windows. Results: Significant health-related factors for driving cessation included having ≥2 chronic diseases (OR = 1.22, p = 0.041), diagnosed depression (OR = 3.64, p = 0.030), Instrumental Activities of Daily Living dependency (OR = 1.67, p = 0.001), visual discomfort (OR = 1.18, p = 0.048), depression risk (OR = 1.34, p = 0.015), suspected cognitive impairment (OR = 1.73, p < 0.001), and poor self-rated health (OR = 1.21, p = 0.029). None of the participants with Parkinson’s were currently driving, whereas polypharmacy (≥5 medications) was not statistically significant (OR = 0.77, p = 0.222). Chronic diseases that may affect driving were also not statistically significant. Conclusions: This study highlights the fact that older drivers may have difficulty recognizing health-related risks that affect driving. To support safe mobility, it is essential to implement a health-centered assessment of driving fitness, including an appropriate evaluation cycle, and promote continuous education to raise awareness among older adults. Full article

As the Buddhist monastic community in Korea has entered an era marked by aging demographics, the issues surrounding the welfare of the order’s monastics in their retirement years have become increasingly pressing. In response, in 2011, the Jogye Order enacted the Monastic Welfare Act and established the Monastic Welfare Society with the aim of enabling monks to fully devote themselves to their religious duties by assuming institutional responsibility for their healthcare, pension, residential welfare, and end-of-life needs. Over a decade since the system’s implementation, the Jogye Order has achieved notable progress towards achieving the Monastic Welfare Act’s aims. However, while the order has stabilized medical coverage for its clergy, there remain considerable gaps in its provisions for income and housing for elderly monastics. This article surveys the Jogye Order’s efforts to establish systemic care for its elderly monastics, with a particular focus on the Jogye Order’s 2011 Monastic Welfare Act and subsequent activities of the Monastic Welfare Society. It then critically examines the current state of eldercare within the order, along with its strengths and weakness, before engaging in a comparative discussion regarding the clerical eldercare and welfare systems provided by both the Korean Catholic Church and the Thai Buddhist community. Full article

Background: The purpose of this study was to investigate differences in cognitive well-being and brain activity between older women with and without mild cognitive impairment (MCI) across varying levels of physical activity. Method: A total of 126 female participants aged over 65 years were recruited and categorized into MCI and non-MCI groups. Cognitive health was evaluated using the Korean versions of the Mini-Mental State Examination (MMSE-K) and the Montreal Cognitive Assessment (MoCA-K), while physical activity levels were quantified with the Physical Activity Scale for the Elderly (PASE-K). Brain activity was assessed through electroencephalography (EEG). Data were analyzed using two-way ANOVA. Results: Results indicated that non-MCI participants consistently demonstrated higher cognitive scores across all physical activity levels. Moreover, individuals with higher physical activity exhibited greater theta wave activity compared with those in the MCI group. Significant group differences were also observed in concentration and stress levels. Conclusion: These findings suggest that higher physical activity levels are associated with better cognitive performance and brain activity in older women. Promoting physical activity may therefore contribute to strategies aimed at supporting healthy cognitive aging, although longitudinal research is required to establish causal relationships. Full article

Objectives: This study examined whether skeletal muscle mass mediates the relationship between sedentary behavior, physical activity, and cardiometabolic health, and if this relationship differs by genders. Methods: Secondary analysis was conducted using data from the 2022–2023 Korean National Health and Nutrition Examination Survey (n = 5956). Cardiometabolic abnormalities were defined as having one or more of the five metabolic syndrome (MS) criteria, while MS was defined as having three or more. Muscle mass relative to body weight was measured by bioelectrical impedance analysis. Sedentary time and recommended moderate-to-vigorous physical activity (MVPA) levels at work, for transportation, and for recreation (≥600 Mets), and strength training (≥2 times/week), were assessed using the Global Physical Activity Questionnaire. Results: Higher MVPA (p < 0.001) and less sedentary time (p < 0.01) were significantly correlated with greater muscle mass in middle-aged and elderly men and women. Mediation analyses, which controlled for MS risk factors, revealed gender differences. In men, the indirect effects of sedentary time, MVPA, and strength training on both cardiometabolic abnormalities (b = 0.007, CI [0.003, 0.013]; b = −0.066, CI [−0.110, −0.033]; b = −0.074, CI [−0.110, −0.033]) and MS (b = 0.007, CI [0.003, 0.011]; b = −0.060, CI [−0.095, −0.032]; b = −0.065, CI [−0.100, −0.035]) were significant, indicating mediation by muscle mass. In women, the indirect effects of these three behaviors on cardiometabolic abnormalities were also mediated by muscle mass (b = 0.003, CI [0.001, 0.006]; b = −0.014, CI [−0.031, −0.002]; b = −0.023, CI [−0.050, −0.003]). However, for MS, sedentary time (b = 0.057, p < 0.001) and MVPA (b = −0.222, p < 0.05) had only direct effects, with no mediation by muscle mass. Furthermore, strength training showed no significant effects. Conclusions: These findings suggest that promoting MVPA and strength training, while reducing sedentary time, can improve cardiometabolic health by increasing muscle mass, though the mediating role of muscle mass for MS differs by gender. Full article

Background/Objectives: Sarcopenia, the age-related decline in skeletal muscle mass and function, is increasingly recognized as an important prognostic factor among elderly patients. This study aimed to evaluate whether computed tomography (CT)-defined sarcopenia independently predicts short-term mortality in elderly Korean trauma patients. Methods: We retrospectively analyzed 722 patients aged ≥65 years admitted to a Korean Level I trauma center between January 2020 and December 2021. Sarcopenia was defined as the lowest sex-specific quartile of skeletal muscle index (SMI) measured at the third lumbar vertebra (L3) within 7 days of admission. Demographics, injury severity, and outcome variables were compared between groups. Kaplan–Meier survival analysis with a 24 h landmark and multivariable Cox regression were applied to identify independent predictors of 30-day mortality. Results: Among 722 patients, 181 (25.1%) were sarcopenic. They were older and had lower body mass index and serum albumin yet showed lower Injury Severity Score (ISS) at presentation. Despite this, in-hospital mortality was higher in sarcopenic patients (15.5% vs. 9.8%, p = 0.036), while 24 h mortality did not differ (4.4% vs. 3.7%, p = 0.663). Landmark analysis starting at 24 h demonstrated significantly worse 30-day survival in the sarcopenia group (log-rank p = 0.028). Multivariable Cox regression confirmed sarcopenia as an independent predictor of 30-day mortality (HR, 2.36; 95% CI, 1.07–5.23; p = 0.034), along with higher ISS and lower Glasgow Coma Scale (GCS) scores. Conclusions: CT-defined sarcopenia at the L3 level independently predicts 30-day mortality in elderly trauma patients and may support early risk stratification. Full article