In a cross-sectional design, this study examined the relationship between functional physical fitness and mild cognitive impairment (MCI) in older adults. A total of 306 older adults (91 men and 215 women) aged 65 years or older were recruited from our local community. A senior fitness test (SFT) was used to assess functional domains of physical fitness consisting of upper and lower body strength, endurance, upper and lower body flexibility, and agility/dynamic balance. Korean version of mini-mental state examine for dementia screening and short-form geriatric depression scale were used to assess global cognitive performance and depression, respectively. Age, sex, education, body mass index, percent body fat, blood lipids, glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed. A composite score of physical fitness was calculated as a sum of z scores for each domain of the SFT parameters. Based on the composited score of physical fitness, subjects were classified as low fit (lower 25 percentile), moderate fit (middle 50 percentile), and high fit (high 25 percentile). Linear contrast analysis using one-way analysis of variance showed significant linear trends for age (p<0.001), education (p<0.001), cognitive function (p<0.001), and depression scale (p=0.006) across incremental composite score of physical fitness. Functional physical fitness was positively associated with age, years of education and global cognitive performance and negatively with depression scale. Logistic regression analyses showed that compared to the low fit group, the moderate (p=0.004) and high fit (p=0.010) groups had significantly lower odds ratios for having MCI even after adjusted for age, sex, education, and body fatness parameters. However, the odds ratios of the moderate (p=0.101) and high fit (p=0.191) groups were not significant when additionally controlling for depression scale and HOMA-IR. The current findings suggest that physical fitness promotion along with treatments of depression and HOMA-IR should be key components of interventions to prevent and/or treat MCI with normal aging.
Adipose Tissue ; Adult* ; Aging ; Body Mass Index ; Dementia ; Depression ; Education ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Logistic Models ; Male ; Mass Screening ; Mild Cognitive Impairment* ; Odds Ratio ; Physical Fitness* ; Pliability

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

BACKGROUND: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. METHODS: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. RESULTS: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. CONCLUSION: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.
Aged ; Caregivers ; Health Expenditures* ; Humans ; Insurance, Long-Term Care ; Long-Term Care*

OBJECTIVE: Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. METHODS: This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. RESULTS: We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. CONCLUSION: Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation.
Australia ; Hand Strength ; Humans ; Information Services ; Korea ; Mental Disorders ; Mental Health ; Mental Health Services ; Organothiophosphorus Compounds ; Prevalence ; Surveys and Questionnaires ; Scotland ; Social Welfare ; Suicide ; United States

Assessment of quality of life (QOL) is a new method to investigate the effectiveness of dietary regimen. Particularly, diet-related QOL is the most appropriate method to estimate social and psychological problems originated from dietary regimen practice. The purpose of this study was to evaluate the diet-related QOL and the correlation between diet-related QOL and health-related QOL, and dietary regimen practice in online diabetes self-help patients who practice the dietary regimen. Sixty one subjects who intended to practice dietary regimen were recruited from online diabetes self-help community, and instructed to fill-up the self report questionnaires. Contents of questionnaire were comprised of general characteristics, clinical characteristics, dietary compliance, and dietary regimen practice. As a result, the mean score of the 'Dietary impact' among the diet-related QOL sub-scales was the lowest suggesting most of the subjects suffer from burden of dietary regimen practice. The "Dietary impact" was correlated with "Taste", "Convenience" and "Cost" (p < 0.05). "Self-care" and "Satisfaction" were positively associated with well-controlled blood glucose and dietary regimen compliance, but negatively associated with "Dietary impact". Diet-related QOL was significantly correlated with the Health-related QOL, particularly the mental and social component (p < 0.05). Diet-related QOL was negatively associated with BMI, and self monitoring blood glucose was negatively correlated with "Self-care" (p < 0.05). In conclusion, Diet-related QOL might be appropriate to evaluate the effects of dietary regimen or nutrition education. The need for dietary education of cognitive-behavioral strategies and problem-solving ability is required.
Blood Glucose ; Compliance ; Diabetes Mellitus ; Humans ; Quality of Life ; Surveys and Questionnaires ; Self Report ; Self-Help Groups

BACKGROUND: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. METHODS: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. RESULTS: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). CONCLUSION: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.
Caregivers ; Food Services ; Health Expenditures ; Humans ; Insurance ; Insurance, Long-Term Care ; Japan ; Korea ; Long-Term Care ; Nutritionists ; Quality of Life

Objectives: Agent Orange is a defoliant chemical that is widely known for its use by the U.S. military during the Vietnam War. It is known to be associated with the occurrence of various diseases in exposed subjects. However, few previous studies have focused on the effects of exposure to Agent Orange on cognitive dysfunction. Methods: A total of 387 male subjects participated in the study. They were divided into those who were exposed to Agent Orange (n=301) and those without exposure (n=86). Both were evaluated with neuropsychological batteries, including the Consortium to Establish a Registry for Alzheimer’s Disease and the Seoul Neuropsychological Screening Battery-Second Edition. Results: The group exposed to Agent Orange showed significantly higher scores in the Rey Complex Figure Test copy and recognition compared to those without exposure. Conclusion In this study, we compared the effects of exposure to Agent Orange on cognitive function in groups that had not yet progressed to dementia. The Agent Orange exposure group showed better results in some tests evaluating visuospatial and memory function.

The claustrum, a brain nucleus located between the cortex and the striatum, has recently been highlighted in drug-related reward processing. Methyl CpG-binding protein-2 (MeCP2) is a transcriptional regulator that represses or activates the expression of the target gene and has been known to have an important role in the regulation of drug addiction in the dopaminergic reward system. The claustrum is an important region for regulating reward processing where most neurons receive dopamine input; additionally, in this region, MeCP2 is also abundantly expressed. Therefore, here, we hypothesized that MeCP2 would be involved in drug addiction control in the Claustrum as well and investigated how claustral MeCP2 regulates drug addiction. To better understand the function of human claustral MeCP2, we established a non-human primate model of methamphetamine (METH) - induced conditioned place preference (CPP). After a habituation of two days and conditioning of ten days, the CPP test was conducted for three days. Interestingly, we confirmed that virus-mediated overexpression of MECP2 in the claustrum showed a significant reduction of METH-induced CPP in the three consecutive days during the testing period. Moreover, they showed a decrease in visit scores (frequency for visit) for the METH-paired room compared to the control group although the scores were statistically marginal. Taken together, we suggest that the claustrum is an important brain region associated with drug addiction, in which MeCP2 may function as a mediator in regulating the response to addictive drugs.

Background and Objectives: Previous studies have reported an association between impaired renal function and poor outcomes after radiofrequency catheter ablation in patients with atrial fibrillation (AF). However, outcomes of cryoballoon ablation (CBA) in patients with renal insufficiency are not fully elucidated. This study aimed to compare outcomes of CBA in AF patients with chronic kidney disease (CKD) versus those without CKD and to assess changes in renal function over 12 months following CBA. Methods: A total of 839 patients (65.1% with non-paroxysmal AF [PAF]) who underwent de novo CBA were prospectively enrolled. We divided patients into two groups based on creatinine clearance rate (CCr) and performed intracardiac echocardiography (ICE)-guided contrast agent-free CBA. Results: In comparison with patients without CKD (CCr >50, n=722), those with CKD (CCr ≤50, n=117) were older and predominantly female, had a lower body mass index, and showed a higher prevalence of heart failure and hypertension. Mean CHA 2 DS 2 -VAS score was significantly higher in CKD group than in non-CKD group. Procedure-related complications were not significantly different between two groups. During a mean follow-up period of 25.4±11.9 months, clinical recurrence occurred in 182 patients (21.7%) and not significantly different between two groups. In multivariate analysis, non-PAF and left atrial size were independent predictors of AF recurrence. CCr levels significantly improved over 12 months after CBA in CKD group. Conclusions ICE-guided contrast-agent-free CBA showed comparable long-term clinical outcomes without increasing procedure-related complications and improvement of renal function over 12 months following CBA in AF patients with CKD.