Aim
Sharing clinical information across care settings is a cornerstone to providing quality care to older people with complex conditions. The purpose of the present study was to examine the ...reliability of the interRAI Long Term Care Facilities (interRAI LTCF) and the interRAI Home Care (interRAI HC), comprehensive and integrated assessment instruments with common core items, in Korea, an Asian county where comprehensive geriatric assessment is not widely used in long‐term care.
Methods
The Korean version of the instruments was developed through field tests, as well as multiple iterations of translations, back‐translations and expert reviews. For the reliability test, a random sample of 908 older people in 27 long‐term care hospitals or nursing homes, or at home with home care, were assessed by regular staff, among which a subsample of 534 people were dually assessed. The Cronbach's alphas of seven major composite scales in the instruments were examined for internal consistency. Interrater reliability was tested using agreement, kappa coefficients and interclass correlation coefficients.
Results
The internal consistencies of all key measures were adequate (Cronbach's alpha ≥0.75). The overall mean kappa statistics of the items in the interRAI LTCF and those in the interRAI HC were 0.78 and 0.89, respectively. All key common items in the interRAI LTCF and the interRAI HC had almost perfect (κ ≥ 0.81) or substantial (0.61 ≤ κ ≤ 0.80) interrater reliability.
Conclusions
The findings show the interRAI LTCF and the interRAI HC have adequate reliability for assessing the function and health of frail older adults across various long‐term settings, which can promote continuity of care for the aged. Geriatr Gerontol Int 2015; 15: 220–228.
This study aimed to assess whether night shift work is associated with the risk of depression by using a meta-analysis of observational studies. We searched PubMed and EMBASE in August, 2016 to ...locate eligible studies and investigated the association between night shift work and the risk of depression, reporting outcome measures with adjusted odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs). In the meta-analysis of a total of 11 observational studies with 9 cross-sectional study, 1 longitudinal study, and 1 cohort study, night shift work was significantly associated with an increased risk of depression (OR/RR, 1.43; 95% CI, 1.24-1.64; I² = 78.0%). Also, subgroup meta-analyses by gender, night shift work duration, type of occupation, continent, and type of publication showed that night shift work was consistently associated with the increased risk of depression. The current meta-analysis suggests that night shift work is associated with the increased risk of depression. However, further large prospective cohort studies are needed to confirm this association.
Abstract
Background
This study evaluated whether baseline results of the Timed Up and Go (TUG) test is associated with future dementia occurrence.
Methods
Using the Korean National Health Insurance ...Service-National Health Screening Cohort database, we identified 49,283 subjects without a dementia diagnosis who participated in the National Screening Program for Transitional Ages at 66 years of age during 2007–2012. Gait impairment was defined as taking longer than 10 seconds to perform the TUG test. Dementia occurrence was defined by the first prescription for acetylcholinesterase inhibitors or N-Methyl-D-Aspartate receptor antagonist with an International Classification of Diseases 10th Revision (ICD-10) code for dementia (F00, F01, F02, F03, G30, F051, or G311) during 2007–2013. Cox proportional hazard regression models were used to assess the hazard ratios for dementia occurrence according to baseline TUG test results.
Results
Mean follow-up period was 3.8 years. Incidence rates of dementia were 4.6 and 6.8 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. The impaired TUG group showed a higher risk of total dementia incidence (adjusted hazard ratio aHR, 1.34; 95% confidence interval 95% CI, 1.14–1.57). Subtype analysis showed that the impaired TUG group had a higher risk of Alzheimer’s disease (aHR, 1.26; 95% CI, 1.06–1.51) and vascular dementia (aHR, 1.65; 95% CI, 1.19–2.30).
Conclusions
The TUG test result was associated with future dementia occurrence. More vigilant follow-up and early intervention to prevent dementia would benefit elderly people with impaired TUG test result.
PurposeThe National Health Insurance Service (NHIS)-Senior was set up to provide high-quality longitudinal data that can be used to explore various aspects of changes in the socio-economical and ...health status of older adults, to predict risk factors and to investigate their health outcomes.ParticipantsThe NHIS-Senior cohort, a Korean nationwide retrospective administrative data cohort, is composed of older adults aged 60 years and over in 2002. It consists of 558 147 people selected by 10% simple random sampling method from a total of 5.5 million subjects aged 60+ in the National Health Information Database. The cohort was followed up through 2015 for all subjects, except for those who were deceased.Findings to dateThe healthcare utilisation and admission rates were the highest for acute upper respiratory infections and influenza (75.2%). The age-standardised (defined with reference to the world standard population) mortality rate for 10 years (through 2012) was 4333 per 100 000 person-years. Malignant neoplasms were the most common cause of death in both sexes (1032.1 per 100 000 person-years for men, 376.7 per 100 000 person-years for women). A total of 34 483 individuals applied for long-term care service in 2008, of whom 17.9% were assessed as grade 1, meaning that they were completely dependent on the help of another person to live daily life.Future plansThe data are provided for the purposes of policy and academic research under the Act on Promotion of the Provision and Use of Public Data in Korea. The NHIS-Senior cohort data are only available for Korean researchers at the moment, but it is possible for researchers outside the country to gain access to the data by conducting a joint study with a Korean researcher. The cohort will be maintained and continuously updated by the NHIS.
We aimed to investigate the effectiveness of the Korean national five-day residential smoking cessation program and the factors affecting the long-term smoking cessation of participants. The ...residential smoking cessation program (2017–2018) recruited smokers with a smoking duration ≥ 20 years and who have attempted to quit smoking more than twice and/or smokers with chronic morbidities. Participants underwent an intensive intervention, including individual psychological therapy, group therapy, medical counseling, and pharmacotherapy. The 6-month continuous abstinence rate (CAR) was assessed via self-reports, the urine cotinine levels, and/or expired-air carbon monoxide levels. Logistic regression was used to analyze the adjusted odds ratio (aOR) to assess factors related to smoking cessation. Overall, 484 participants who completed the residential program and questionnaire were evaluated. The 3- and 6-month CAR were 81.82% and 63.22%, respectively. The aOR of 6-month continuous abstinence was lower among participants with severe nicotine dependence (aOR: 0.46, 95% confidence interval CI: 0.26–0.81) and higher among participants with combination therapy of varenicline with short-term nicotine replacement therapy (NRT) (aOR: 1.64, 95% CI: 1.07–2.51), with higher self-efficacy (aOR: 1.97, 95% CI: 1.15–3.37). The residential smoking cessation program was effective. High self-efficacy, combination therapy of varenicline with short-term NRT, and low nicotine dependence were associated with a high 6-month CAR.
Depression is suggested to be associated with cardiovascular disease, including ischemic heart disease and cerebrovascular disease. This study investigated the impact of depression on cardiovascular ...disease in the elderly population in Korea.
This retrospective cohort study was performed using the Senior Cohort database released by the Korean National Health Insurance Services from January 1, 2008 to December 31, 2012, or January 1, 2009 to December 31, 2013. The study group constituted participants newly diagnosed with depression, but not cardiovascular disease. The control group constituted participants with no past history of depression or cardiovascular disease, and were not diagnosed with depression during the follow-up period. During the 5-year follow-up period, development of ischemic heart disease or cerebrovascular disease was assessed. Depression and cardiovascular disease were identified using the International Classification of Diseases, 10th revision, Clinical Modification codes. The data was analyzed using Cox proportional hazards model.
The hazard ratio (HR) between depression and ischemic heart disease was 1.38 (95% confidence interval CI, 1.23 to 1.55) and the HR between depression and cerebrovascular disease was 1.46 (95% CI, 1.32 to 1.62), after adjusting all confounding variables.
Independent of other cardiovascular risk factors, depression increased the risk of ischemic heart disease by 38% and cerebrovascular disease by 46% among older adults in Korea. Since depression may increase the risk of cardiovascular disease, future research should focus on the diagnosis and prevention of cardiovascular disease in people with depression.
We investigated the association between dietary habits, evaluated using the modified Mini Dietary Assessment Index for Koreans (MDA), and lipid control among patients aged ≥20 years who had used ...pravastatin for dyslipidemia for 6 months. Participants were administered questionnaires regarding sociodemographic characteristics and lifestyle factors. Odds ratios and 95% confidence intervals for the control of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC) at 6 months for each category of the modified MDA items were calculated through multivariate logistic regression analysis. The odds for controlled LDL-C was higher among those who consumed cholesterol-rich foods <1 time/week (3.27, 1.25-8.57) than for those who did so ≥4 times/week. The odds for controlled TG was higher among those who always consumed dairy products (2.96, 1.36-6.44), ate protein-rich foods three times/day (2.94, 1.06-8.10), and had a regular eating schedule (3.02, 1.30-7.00) than among those who did not have any of these. The odds for controlled TC was higher among those with a regular eating schedule (3.47, 1.55-7.76) than among their counterparts. Patients with dyslipidemia should consume less cholesterols, consume more dairy and protein-rich foods, and follow a regular eating schedule to control lipid profiles.
Associations between body mass index (BMI), body fat percentage (BF%), and health risks differ between Asian and European populations. BMI is commonly used to diagnose obesity; however, its accuracy ...in detecting adiposity in Koreans is unknown. The present cross-sectional study aimed at assessing the accuracy of BMI in determining BF%-defined obesity in 6,017 subjects (age 20-69 yr, 43.6% men) from the 2009 Korean National Health and Nutrition Examination Survey. We assessed the diagnostic performance of BMI using the Western Pacific Regional Office of World Health Organization reference standard for BF%-defined obesity by sex and age and identified the optimal BMI cut-off for BF%-defined obesity using receiver operating characteristic curve analysis. BMI-defined obesity (≥25 kg/m(2)) was observed in 38.7% of men and 28.1% of women, with a high specificity (89%, men; 84%, women) but poor sensitivity (56%, men; 72% women) for BF%-defined obesity (25.2%, men; 31.1%, women). The optimal BMI cut-off (24.2 kg/m(2)) had 78% sensitivity and 71% specificity. BMI demonstrated limited diagnostic accuracy for adiposity in Korea. There was a -1.3 kg/m(2) difference in optimal BMI cut-offs between Korea and America, smaller than the 5-unit difference between the Western Pacific Regional Office and global World Health Organization obesity criteria.
Korea has recently attained the aged society status and the growth rate of the aging population will be among the most rapid worldwide. The objective of this study was to develop a credible list of ...potentially inappropriate medications (PIMs) for Korean older adults.
A new Korean PIMs list was produced through a comprehensive structured expert survey (modified Delphi method). To generate an expert panel, we invited the nomination of experts in geriatric medication from the Korean Geriatric Society, the Korean Academy of Clinical Geriatrics, the Korean Academy of Family Medicine, the Korean Association for Geriatric Psychiatry, and the Korean Association of Geriatric Hospitals. Based on their recommendation, the expert panel consisted of 14 geriatric specialists, including 10 geriatricians (7 family medicine doctors and 3 internal medicine doctors), 3 geriatric psychiatrists, and 1 clinical pharmacist. After 4 rounds, the new Korean PIMs list was finalized.
Sixty-two drugs were classified as PIMs for older adults irrespective of comorbidities, including antipsychotics, tricyclic antidepressants, benzodiazepines, non-steroidal anti-inflammatory drugs, and first-generation antihistamines. Forty-eight drugs or drug categories were classified as PIMs for 18 specific conditions that older adults encounter frequently. The expert panel presented the rationale and comments including preferred therapeutic alternatives and exceptional situations for each item.
We presented a "user-friendly" PIMs list for Korean older adults. Further prospective studies to validate its usefulness in clinical settings and regular updating of the list are required. It is also important to disseminate this list to doctors who prescribe medication to older people.
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