Background: Numerous studies have consistently demonstrated that depression can be associated with cognitive function decline, primarily focusing on older adults due to the neurodegenerative characteristics of dementia. With persistent depression frequentlyreported in patients with early-onset or young-onset dementia, this study aimed to assess the impact of depression, specifically thechanges in depressive symptoms over time, on the risk of cognitive function decline in middle-aged adults in Korea. Methods: This retrospective study utilized data from the first four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA), focus-ing on middle-aged adults with normal cognitive function at baseline. Changes in depressive symptoms were categorized into four groups based on the CES-D score, and their association with cognitive function decline was evaluated using a multivariate logistic regression model. Results: Of the initial 10,254 participants, 3,400 were included in the analysis. Depressive status, particularlynewly onset (adjusted odds ratio [aOR] 1.96; 95% confidence interval [CI] 1.32-2.93) and persistent depression groups (aOR 5.59;95% CI 2.90-10.78), were significantly associated with cognitive function decline. In contrast, recovery from depressive symptoms was not significantly associated with cognitive function decline (p=0.809). Conclusions Our study showed a significant associationbetween changes in depressive symptoms and cognitive function decline in middle-aged Korean adults. This suggests that management of depressive symptoms could be crucial for the prevention of cognitive function decline in this population.

Background: Numerous studies have consistently demonstrated that depression can be associated with cognitive function decline, primarily focusing on older adults due to the neurodegenerative characteristics of dementia. With persistent depression frequentlyreported in patients with early-onset or young-onset dementia, this study aimed to assess the impact of depression, specifically thechanges in depressive symptoms over time, on the risk of cognitive function decline in middle-aged adults in Korea. Methods: This retrospective study utilized data from the first four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA), focus-ing on middle-aged adults with normal cognitive function at baseline. Changes in depressive symptoms were categorized into four groups based on the CES-D score, and their association with cognitive function decline was evaluated using a multivariate logistic regression model. Results: Of the initial 10,254 participants, 3,400 were included in the analysis. Depressive status, particularlynewly onset (adjusted odds ratio [aOR] 1.96; 95% confidence interval [CI] 1.32-2.93) and persistent depression groups (aOR 5.59;95% CI 2.90-10.78), were significantly associated with cognitive function decline. In contrast, recovery from depressive symptoms was not significantly associated with cognitive function decline (p=0.809). Conclusions Our study showed a significant associationbetween changes in depressive symptoms and cognitive function decline in middle-aged Korean adults. This suggests that management of depressive symptoms could be crucial for the prevention of cognitive function decline in this population.

Background: Numerous studies have consistently demonstrated that depression can be associated with cognitive function decline, primarily focusing on older adults due to the neurodegenerative characteristics of dementia. With persistent depression frequentlyreported in patients with early-onset or young-onset dementia, this study aimed to assess the impact of depression, specifically thechanges in depressive symptoms over time, on the risk of cognitive function decline in middle-aged adults in Korea. Methods: This retrospective study utilized data from the first four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA), focus-ing on middle-aged adults with normal cognitive function at baseline. Changes in depressive symptoms were categorized into four groups based on the CES-D score, and their association with cognitive function decline was evaluated using a multivariate logistic regression model. Results: Of the initial 10,254 participants, 3,400 were included in the analysis. Depressive status, particularlynewly onset (adjusted odds ratio [aOR] 1.96; 95% confidence interval [CI] 1.32-2.93) and persistent depression groups (aOR 5.59;95% CI 2.90-10.78), were significantly associated with cognitive function decline. In contrast, recovery from depressive symptoms was not significantly associated with cognitive function decline (p=0.809). Conclusions Our study showed a significant associationbetween changes in depressive symptoms and cognitive function decline in middle-aged Korean adults. This suggests that management of depressive symptoms could be crucial for the prevention of cognitive function decline in this population.

Background: Numerous studies have consistently demonstrated that depression can be associated with cognitive function decline, primarily focusing on older adults due to the neurodegenerative characteristics of dementia. With persistent depression frequentlyreported in patients with early-onset or young-onset dementia, this study aimed to assess the impact of depression, specifically thechanges in depressive symptoms over time, on the risk of cognitive function decline in middle-aged adults in Korea. Methods: This retrospective study utilized data from the first four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA), focus-ing on middle-aged adults with normal cognitive function at baseline. Changes in depressive symptoms were categorized into four groups based on the CES-D score, and their association with cognitive function decline was evaluated using a multivariate logistic regression model. Results: Of the initial 10,254 participants, 3,400 were included in the analysis. Depressive status, particularlynewly onset (adjusted odds ratio [aOR] 1.96; 95% confidence interval [CI] 1.32-2.93) and persistent depression groups (aOR 5.59;95% CI 2.90-10.78), were significantly associated with cognitive function decline. In contrast, recovery from depressive symptoms was not significantly associated with cognitive function decline (p=0.809). Conclusions Our study showed a significant associationbetween changes in depressive symptoms and cognitive function decline in middle-aged Korean adults. This suggests that management of depressive symptoms could be crucial for the prevention of cognitive function decline in this population.

Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

Background: & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

Background: & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.