BACKGROUND: Dementia is the most important factor affecting everyday life of the elderly and there have been studies on the relationship between dementia and social withdrawal or loneliness. However, there is a lack of investigations on the relationship between loneliness and cognitive function in the elderly living alone. METHODS: Ninety five community-dwelling elderly people registered to Sungbook elderly welfare center in Seoul, who were living alone, were enrolled in the study. Personal visits by three pre-trained researchers were made during April 2006. One year later, 11 elderly dropped out, and 84 elderly were interviewed in the same way. They were interviewed based on loneliness scale, social support, Hasegawa dementia scale, instrumental activities of daily living, and depression. RESULTS: The mean age of the subjects was 78.3 years. Most of them were women (90.5%) and education level was low (no schooling in 69%). The loneliness scale did not change much during one year (P=0.63), but the instrumental activities of daily living (IADL) score had worsened from 10.5 to 11.2 (P=0.002) The mean Hasegawa dementia scale score decreased from 23.2 to 21.0 during one year (P<0.001). Multivariate regression analysis for the one-year difference in Hasegawa Dementia Scale revealed loneliness was a significant factor after adjusting for age, the level of education, social support, IADL score, and depression (regression coefficient=-0.712, P=0.02). CONCLUSION: Loneliness was associated with a decline in cognitive function in the elderly people living alone. In contrast, social withdrawal and depression had no effect on changes of cognitive function during one year.
Activities of Daily Living ; Aged ; Dementia ; Depression ; Female ; Humans ; Loneliness ; Prospective Studies

BACKGROUND: With the number of geriatric population on a steep increase, the roles of family physicians broaden to give comprehensive medical care to the elderly. Therefore, geriatrics is becoming increasingly more important for the residents of family medicine. The authors have surveyed and researched on resident's current attention, actual training conditions, and future needs on geriatrics. METHODS: Family medicine residents in 79 hospitals registered to Korean Family Medicine Resident Union were enrolled. By means of electronic and postage mail surveys, informations were gathered; including demographics, the order of importance of nine training curricula, the necessity of training itself, the facility and academic conference of geriatrics training. RESULTS: A total of 173 residents in 45 hospitals replied with return rates of 51.9%. Among the total, 169 (97.7%) of the answered agreed on the necessity of geriatrics training. Of the nine curricula, geriatrics was considered the most important. And residents considered family medicine outpatient department and inpatient ward to be the most important place for geriatrics training. Furthermore, the residents considered elderly's diseases or symptoms as more important conference title, but the parameters such as the quality of life, physiology of aging, care in nursing home were considered less important. CONCLUSION: The geriatrics training program is not up to the standards of residents' satisfaction. This is considered to be due to the absence of a formal training program. To provide a better care for the elderly, it is compulsory to gain broad knowledge of geriatrics and actual experience out in the field.
Aged ; Aging ; Curriculum ; Demography ; Electronics ; Electrons ; Geriatrics ; Humans ; Hypogonadism ; Inpatients ; Internship and Residency ; Mitochondrial Diseases ; Nursing Homes ; Ophthalmoplegia ; Outpatients ; Physicians, Family ; Postal Service ; Quality of Life

BACKGROUND: Hearing impaired people have a lot of difficulty in communicating when they visit medical institutions. This study was to reveal the family physicians' perception and attitude for the hearing impaired people, and the effect of those factors on the actual physicians' practice behavior for the disabled. METHODS: We sent questionnaires by post mail to 1,000 members listed in the 2007 address book of the Korean Association of Family Medicine. RESULTS: Among the total of 90 family physicians who had answered, 72 (80.8%) had willing attitude to treat the hearing impaired people, and the most important reason was that it was essentially a doctor's duty. In the group who were unwilling to treat the disabled, the most principal reason was that they were not equipped with sufficient facility and medical system. Gender was the only factor affecting the physicians' attitude significantly and the female doctors had a higher intention to treat the hearing impaired people than male doctors (P=0.035). Age, location of hospital, number of patients, practical experience of hearing impaired people had no significant effect on doctors' attitude. The number of physicians who volunteered to participate for the hearing impaired people's health promotion personally was significantly higher in the group of treatment intention (P=0.007). Nevertheless, few physicians had the willingness to equip the hospital facility for the hearing disabled, even in the group of willingness to treat the disabled. The most important reason was that very few disabled patients visit their clinic, and so forth they felt no necessity to improve and re-organize their clinical environment. CONCLUSION: Most family physicians are willing to treat hearing impaired people. But even in the willing group, almost all of them are unwilling to improve or equip the medical facilities for the hearing impaired people personally, because only a few disabled people visit the primary care hospital in the real practice.
Female ; Health Promotion ; Hearing ; Humans ; Intention ; Male ; Physicians, Family ; Postal Service ; Primary Health Care ; Surveys and Questionnaires

BACKGROUND: Nowadays, decreased physical activity is considered to be a contributor to increase the prevalence of many diseases such as obesity, coronary heart disease and so on. Many researches demonstrated that regular physical activity reduce all cause mortality. To increase the physical activities of the population, accurate estimation of the activities is needed. Actical and actigraph are confirmed as accurate tools to measure physical activities. But the target populations of the validity studies were not Asian people. Therefore, the accuracy of the accelerometers should be confirmed in Asian people. The accuracy of the tools could be different. Therefore head to head comparison study between the tools would be needed. METHODS: Thirty volunteers from the community, ages over 20 yrs, were recruited. The participants put on the two accelerometers (Actical, Actigraph) on the waists, secured with elastic belts, and performed a session of rest and three structured activities (two walking speeds, 4 km/hr and 6 km/hr, and one jogging speed, 8 km/hr). During each activity, expired respiratory gases were collected, and oxygen consumption (VO2) was measured by indirect calorimetry (Model Quark beta2(R)). The calories measured by gas analyzer and two accelerometers were compared by correlation analysis using SPSS program. RESULTS: Pearson correlation coefficient between gas analyzer and two accelerometers was calculated at three structured activities. The r in Actical was 0.747, 0.785, and 0.677, at speed of 4, 6, 8 km/hr, respectively (P<0.05), and the same measures in Actigraph was 0.617, 0.737, and 0.530 (P<0.05), respectively. Pearson correlation coefficient was also calculated between the two accelerometers, and the r was 0.881, 0.927, and 0.824, at each speed. CONCLUSION: The Actical and Actigraph are valid tools for measuring physical activities in Korean people.
Asian Continental Ancestry Group ; Calorimetry, Indirect ; Coronary Disease ; Gases ; Head ; Health Services Needs and Demand ; Humans ; Jogging ; Motor Activity ; Obesity ; Oxygen Consumption ; Prevalence ; Walking

BACKGROUND: We assessed the state of diabetes control in Korean adults from the 2001 Korean National Health and Nutrition Survey. METHODS: A total of 271 adult diabetes patients (125 males, 146 females) were identified from the health interview survey. Diabetes control status was assessed by the American Diabetic Association (ADA) recommendations. Socioeconomic characteristics and the health status were assessed by an interview and the health- related behavior was assessed by self-questionnaire. A one-day 24-hour recall was used for the dietary assessment. Blood pressure and anthropometric measurements were done. Fasting blood was drawn for glucose, HbA1c, and lipids profile. RESULTS: The proportions of patients reaching the recommended goals for fasting plasma glucose (< or =130 mg/dl), HbA1c (<7%), blood pressure (<130/80 mmHg), low density lipoprotein cholesterol (<100 mg/dl), triglyceride (<200 mg/dl), and high density lipoprotein cholesterol (>45 mg/dl for males, >55 mg/dl for females) were 57.2%, 19.9%, 24.4%, 27.8%, 64.5% and 20.7%, respectively. Body mass index, and smoking in males and age, and diabetes duration in females were associated with HbA1c level. CONCLUSION: This study shows that diabetes in Korean adult is not adequately controlled. National effort is needed to achieve the recommended treatment goals and to manage modifiable risk factors such as obesity and smoking.
Adult ; Blood Pressure ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diabetes Mellitus ; Fasting ; Female ; Glucose ; Humans ; Lipoproteins ; Male ; Obesity ; Plasma ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Metabolic syndrome has been introduced to increase the incidence of cardiovascular diseases and type 2 diabetes mellitus. Our aim of this study was to investigate the association of fasting plasma glucose levels and metabolic syndrome in normoglycemic adults. METHODS: We examined lifestyle factors, anthropometric and laboratory measurement of adults with no personal history of diabetes and normal fasting glucose from the Korean National Health and Nutrition Examination Survey 2001. We categorized the fasting plasma glucose levels below 100 mg/dl into the quintiles and assessed the association of metabolic syndrome with increasing glycemia in normoglycemic adults. RESULTS: Quintiles of normal fasting plasma glucose levels showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, and obesity in normoglycemic adults (P<0.001). Hypertriglyceridemia, low HDL-cholesterolemia, smoking, heavy drinking, and physical activity were of no significance. A multivariate model, adjusted for age, sex, smoking status, physical activity, and heavy drinking, revealed a progressively increased odds ratio of metabolic syndrome, 1.05 (95% CI, 0.76~1.44), 1.15 (95% CI, 0.84~1.58), 1.33 (95% CI, 0.99~1.80), 1.55 (95% CI, 1.14~2.10), with increasing fasting plasma glucose levels, as compared with fasting plasma glucose level of 81 mg/dl or less (P<0.001). CONCLUSION: Higher fasting plasma glucose levels within the normoglycemic range may constitute a risk of metabolic syndrome in normoglycemic adults.
Adult ; Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Drinking ; Fasting ; Glucose ; Humans ; Hypertension ; Hypertriglyceridemia ; Incidence ; Life Style ; Motor Activity ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Odds Ratio ; Plasma ; Risk Factors ; Smoke ; Smoking

Dengue fever is an acute febrile illness caused by dengue virus infection. Found predominantly in tropical urban areas, dengue virus is transmitted to humans by a female mosquito vector, Aedes aegypti. The clinical features of dengue fever include fever, headache, skin rash and bleeding. These symptoms are usually mild and not fatal, but dengue hemorrhagic fever is life threatening without proper management. The diagnosis of dengue fever can be established with a dengue virus-infected cell culture or with isolated dengue IgM. No specific treatment exists for dengue fever except for symptomatic management. With the recent global increase of dengue fever incidence, the number of cases of dengue fever in returning travelers is on the increase in Korea. Therefore, it is possible that Korean primary physicians will confront dengue fever cases. We report two cases of dengue fever that we experienced in the Department of Family Medicine in 2007.
Aedes ; Cell Culture Techniques ; Culicidae ; Dengue ; Dengue Hemorrhagic Fever ; Dengue Virus ; Exanthema ; Female ; Fever ; Headache ; Hemorrhage ; Humans ; Immunoglobulin M ; Incidence ; Korea

BACKGROUND: It is well recognized that thyroid hormone stimulates bone turnover, increasing bone resorption, thus affecting bone mineral density, but few data are available on untreated subclinical hypothyroidism. The aim of this study was to examine whether bone mineral density is increased in postmenopausal subclinical hypothyroidism patients compared with postmenopausal normal thyroid function women, and to evaluate the relationship between thyroid hormones (TSH, FT(4)) and bone mineral density or various biochemical markers of bone metabolism. METHODS: This was a cross sectional study of 132 postmenopausal women aged from 51 to 70 who undertook health screening program in Pundang CHA general hospital from 1996 to 2001. They were divided into two groups; subclinical hypothyroidism group (n=52) and normal thyroid function group (n=80) matched by age. RESULTS: The total bone mineral density was significantly increased in the subclinical hypothyroid group than in the normal group (P<0.05). The serum osteocalcin was lower in the subclinical hypothyroidism group (P<0.05), but neither the alkaline phosphatase nor the deoxypyridinoline showed any significance. For all participants in this study, TSH, but not FT(4), exhibited significant correlation with the total bone mineral density (r=0.188, P<0.05), and with the osteocalcin (r=-0.191, P<0.05). Multiple regression analysis identified the TSH as an independent predictor of the total bone mineral density (beta=0.0410; P< 0.05). CONCLUSION: This study indicated that subclinical hypothyroidism is one of the factors which can elevate bone mineral density in postmenopausal women.
Aged ; Alkaline Phosphatase ; Amino Acids ; Biomarkers ; Bone Density ; Bone Resorption ; Female ; Hospitals, General ; Humans ; Hypothyroidism ; Mass Screening ; Osteocalcin ; Thyroid Gland ; Thyroid Hormones

BACKGROUND: The present study purposed to execute group temperance education for heavy drinkers, and to examine how much the participants' drinking behavior is improved. METHODS: We ran a drinking class composed of 4 sessions of group temperance education with 40 male heavy drinkers selected through the case management program of the National Health Insurance Corporation, and compared their drinking behavior before, right after, and 12 weeks after the class. RESULTS: The mean (SD) drinks per week was 4.8 (1.8) before the drinking class, 3.3 (2.3) (P<0.001) right after the completion of the class, and 3.6 (2.2) (P<0.001) 12 weeks after the class, showing a significant decrease. The mean (SD) alcohol intake per drink also decreased significantly from 14.4 (15.6) drinks before the drinking class to 9.3 (15.5) (P<0.001) right after the completion of the class and to 12.0 (16.6) (P<0.001) 12 weeks after the class. The mean (SD) alcohol use disorder identification test score improved significantly from 27.7 (6.3) before the drinking class to 17.8 (11.1) (P<0.001) right after the completion of the class and 20.5 (8.8) (P<0.001) 12 weeks after the class. The number of heavy drinkers decreased significantly from 40 (100.0%) before the drinking class to 26 (65.0%) right after the completion of the class and 28 (70.0%) 12 weeks after the class (P<0.001), and the number of binge drinkers also decreased significantly from 40 (100.0%) before the drinking class to 27 (67.5%) right after the completion of the class and 28 (70.0%) 12 weeks after the class (P<0.001). CONCLUSION: The results of this study showed that group temperance education by primary care physicians improved heavy drinkers' drinking behavior.
Case Management ; Drinking ; Drinking Behavior ; Humans ; Male ; National Health Programs ; Physicians, Primary Care ; Temperance

BACKGROUND: Many clinical measures have been used to assess fall risk in elderly adults. The first objective of this study was to assess the clinical availability of maximal step length (MSL) as a measurement predicting falling probability in future. The second objective of this study was to try to find out how to use MSL more easily in a clinical setting. METHODS: The study population consisted of 50 community-dwelling people (> or =60 yrs). Demographic data were reviewed by self-recorded questionnaire and MSL, US and TUG had been done when the subjects visited a clinic in March and April 2004. They revisited the clinic after one year and information of fall incidence was obtained and their visual acuity was examined. To examine the association between many performance tests (MSL Unipedal stance, Timed up and go) and their real falling after tests, we analysed data by Mann-Whitney rank Test, pearson correlation and multiple regression. RESULTS: The average MSL predicted future falling (P-value 0.025), but Unipedal stance, Timed up and go did not. The predicting ability of MSL was preserved using many MSL measures (average MSL corrected by leg length and height, one direction measure among six directions of MSL, and average of left and right three directions of MSL). CONCLUSION: This study showed that MSL had the ability to predict elderly adults' falling in future. And this study showed that MSL can be used more easily in a clinical setting.
Adult ; Aged ; Humans ; Incidence ; Leg ; Visual Acuity ; Surveys and Questionnaires