1.The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults
Eunji KIM ; Kiho SUNG ; Chang Oh KIM ; Yoosik YOUM ; Hyeon Chang KIM
Journal of Preventive Medicine and Public Health 2023;56(1):31-40
Objectives:
This study investigated the effect of cognitive impairment on the association between social network properties and mortality among older Korean adults.
Methods:
This study used data from the Korean Social Life, Health, and Aging Project. It obtained 814 older adults’ complete network maps across an entire village in 2011-2012. Participants’ deaths until December 31, 2020 were confirmed by cause-of-death statistics. A Cox proportional hazards model was used to assess the risks of poor social network properties (low degree centrality, perceived loneliness, social non-participation, group-level segregation, and lack of support) on mortality according to cognitive impairment.
Results:
In total, 675 participants (5510.4 person-years) were analyzed, excluding those with missing data and those whose deaths could not be verified. Along with cognitive impairment, all social network properties except loneliness were independently associated with mortality. When stratified by cognitive function, some variables indicating poor social relations had higher risks among older adults with cognitive impairment, with adjusted hazard ratios (HRs) of 2.12 (95% confidence interval [CI], 1.34 to 3.35) for social nonparticipation, 1.58 (95% CI, 0.94 to 2.65) for group-level segregation, and 3.44 (95% CI, 1.55 to 7.60) for lack of support. On the contrary, these effects were not observed among those with normal cognition, with adjusted HRs of 0.73 (95% CI, 0.31 to 1.71), 0.96 (95% CI, 0.42 to 2.21), and 0.95 (95% CI, 0.23 to 3.96), respectively.
Conclusions
The effect of social network properties was more critical among the elderly with cognitive impairment. Older adults with poor cognitive function are particularly encouraged to participate in social activities to reduce the risk of mortality.
2.Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project
Sung-Ha LEE ; Hyeok-Hee LEE ; Kiho SUNG ; Yoosik YOUM ; Hyeon Chang KIM
Epidemiology and Health 2023;45(1):e2023041-
OBJECTIVES:
The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults.
METHODS:
From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH.
RESULTS:
Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the crosssectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02).
CONCLUSIONS
Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.
3.Gender role stereotypes, patriarchal attitudes, and cognitive function in the elderly rural Korean population: a cross-sectional study
Hye Rin CHOI ; Byeonggwan HA ; Ye Jin JEON ; Yoosik YOUM ; Hyeon Chang KIM ; Sun Jae JUNG
Epidemiology and Health 2021;43(1):e2021023-
OBJECTIVES:
We analyzed whether gender role stereotypes (GRS) and patriarchal attitudes are associated with cognitive function in an elderly community.
METHODS:
We analyzed data from 580 people enrolled in the Korean Social Life, Health, and Aging Project. The degrees to which respondents held stereotypical beliefs about gender roles and had patriarchal mindsets were measured using a questionnaire. Based on participants’ responses, we divided respondents into 2 groups—those with conservative mindsets and those with open mindsets—according to the median score for each of the 2 variables. Cognitive function was assessed using the Mini-Mental State Examination, Korean version (MMSE-K). Cognitive impairment was defined as an MMSE-K score ≤21 points. Multivariable logistic regression was performed, adjusting for gender, age, socio-demographic and lifestyle factors, and social network size. Age and lifestyle factors were stratified.
RESULTS:
Compared to those with open mindsets, those with conservative mindsets regarding gender roles and patriarchal norms had adjusted odds ratios of 1.88 (95% confidence interval [CI], 1.11 to 3.19) and 1.67 (95% CI, 1.00 to 2.79) for cognitive impairment, respectively. In the stratified analysis, subgroups with younger age and a good lifestyle maintained a protective association with cognitive impairment.
CONCLUSIONS
GRS and a patriarchal mindset were marginally significantly associated with cognitive impairment among women later in life.
4.Association between masticatory function and cognitive impairment in the elderly
Taejun PARK ; Hyojin HEO ; Min-Jeong CHO ; Hyeon Chang KIM ; Yoosik YOUM ; Keun-Bae SONG ; Youn-Hee CHOI
Journal of Korean Academy of Oral Health 2021;45(2):57-63
Objectives:
With the surge in the elderly population, a growing interest in the prevention and treatment of geriatric diseases has been observed, along with awareness of the severity of problems associated with dementia, a cognitive impairment. The purpose of this study was to investigate the correlation between chewing ability and cognitive function among elderly people residing in a rural area.
Methods:
A total of 162 elderly individuals, aged between 65 and 97 years, were surveyed. Trained examiners conducted interviews and assessments of chewing ability, on the basis of the number of remaining teeth, denture status, masticatory performance evaluating gum, ShadeEye-NCC measuring overall change in color of the gum (ΔE), and T-Scan® III analyzing distribution of occlusion patterns. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination-Dementia Screening (MMSE-DS) tool.
Results:
Participants with a low score in the MMSE-DS were found to have distinguishably lower denture need, smaller number of remaining teeth, and lesser color change in the masticatory performance evaluating gum. In the cognitive impairment group, a tendency of having unilateral and anterior occlusion led to occlusal discomfort and chewing difficulties.
Conclusions
The study highlights important associations between chewing ability and cognitive function. The finding corroborates that tooth loss may be a predictive risk factor for cognitive impairment.
5.Gender role stereotypes, patriarchal attitudes, and cognitive function in the elderly rural Korean population: a cross-sectional study
Hye Rin CHOI ; Byeonggwan HA ; Ye Jin JEON ; Yoosik YOUM ; Hyeon Chang KIM ; Sun Jae JUNG
Epidemiology and Health 2021;43(1):e2021023-
OBJECTIVES:
We analyzed whether gender role stereotypes (GRS) and patriarchal attitudes are associated with cognitive function in an elderly community.
METHODS:
We analyzed data from 580 people enrolled in the Korean Social Life, Health, and Aging Project. The degrees to which respondents held stereotypical beliefs about gender roles and had patriarchal mindsets were measured using a questionnaire. Based on participants’ responses, we divided respondents into 2 groups—those with conservative mindsets and those with open mindsets—according to the median score for each of the 2 variables. Cognitive function was assessed using the Mini-Mental State Examination, Korean version (MMSE-K). Cognitive impairment was defined as an MMSE-K score ≤21 points. Multivariable logistic regression was performed, adjusting for gender, age, socio-demographic and lifestyle factors, and social network size. Age and lifestyle factors were stratified.
RESULTS:
Compared to those with open mindsets, those with conservative mindsets regarding gender roles and patriarchal norms had adjusted odds ratios of 1.88 (95% confidence interval [CI], 1.11 to 3.19) and 1.67 (95% CI, 1.00 to 2.79) for cognitive impairment, respectively. In the stratified analysis, subgroups with younger age and a good lifestyle maintained a protective association with cognitive impairment.
CONCLUSIONS
GRS and a patriarchal mindset were marginally significantly associated with cognitive impairment among women later in life.
6.Association between masticatory function and cognitive impairment in the elderly
Taejun PARK ; Hyojin HEO ; Min-Jeong CHO ; Hyeon Chang KIM ; Yoosik YOUM ; Keun-Bae SONG ; Youn-Hee CHOI
Journal of Korean Academy of Oral Health 2021;45(2):57-63
Objectives:
With the surge in the elderly population, a growing interest in the prevention and treatment of geriatric diseases has been observed, along with awareness of the severity of problems associated with dementia, a cognitive impairment. The purpose of this study was to investigate the correlation between chewing ability and cognitive function among elderly people residing in a rural area.
Methods:
A total of 162 elderly individuals, aged between 65 and 97 years, were surveyed. Trained examiners conducted interviews and assessments of chewing ability, on the basis of the number of remaining teeth, denture status, masticatory performance evaluating gum, ShadeEye-NCC measuring overall change in color of the gum (ΔE), and T-Scan® III analyzing distribution of occlusion patterns. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination-Dementia Screening (MMSE-DS) tool.
Results:
Participants with a low score in the MMSE-DS were found to have distinguishably lower denture need, smaller number of remaining teeth, and lesser color change in the masticatory performance evaluating gum. In the cognitive impairment group, a tendency of having unilateral and anterior occlusion led to occlusal discomfort and chewing difficulties.
Conclusions
The study highlights important associations between chewing ability and cognitive function. The finding corroborates that tooth loss may be a predictive risk factor for cognitive impairment.
7.Association of social network size and composition with physical activity in Korean middle-aged adults
Moon Su KWAK ; So Mi Jemma CHO ; Jee-Seon SHIM ; Dae Jung KIM ; Yoosik YOUM ; Hyeon Chang KIM
Epidemiology and Health 2020;42(1):e2020070-
OBJECTIVES:
Physical activity (PA) is an established protective factor for many chronic diseases. Numerous studies have established positive relationships between social networks and PA. Accordingly, this study examined the relationship between social network structures (specifically the network size and the number and proportion of same-sex alters) and self-reported PA in Korean middle-age adults, where the term “alter” refers to a respondent’s social network members.
METHODS:
We analyzed 8,092 participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. We assessed the association between each network structure variable and PA level using a linear regression model. Then, we employed logistic regression to evaluate associations between social network structure and adherence to guideline-recommended exercise levels. Socio-demographic factors and health status measures were used as covariates.
RESULTS:
In both sexes, the social network size and proportion of same-sex network members showed positive relationships with total and moderate-to-vigorous PA. Notably, female participants with a greater number of kin were more likely to satisfy the recommended amount of total PA.
CONCLUSIONS
These findings suggest that large scale, same-sex intervention programs can help to achieve recommended PA regimens.
8.Association of social network size and composition with physical activity in Korean middle-aged adults
Moon Su KWAK ; So Mi Jemma CHO ; Jee-Seon SHIM ; Dae Jung KIM ; Yoosik YOUM ; Hyeon Chang KIM
Epidemiology and Health 2020;42(1):e2020070-
OBJECTIVES:
Physical activity (PA) is an established protective factor for many chronic diseases. Numerous studies have established positive relationships between social networks and PA. Accordingly, this study examined the relationship between social network structures (specifically the network size and the number and proportion of same-sex alters) and self-reported PA in Korean middle-age adults, where the term “alter” refers to a respondent’s social network members.
METHODS:
We analyzed 8,092 participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. We assessed the association between each network structure variable and PA level using a linear regression model. Then, we employed logistic regression to evaluate associations between social network structure and adherence to guideline-recommended exercise levels. Socio-demographic factors and health status measures were used as covariates.
RESULTS:
In both sexes, the social network size and proportion of same-sex network members showed positive relationships with total and moderate-to-vigorous PA. Notably, female participants with a greater number of kin were more likely to satisfy the recommended amount of total PA.
CONCLUSIONS
These findings suggest that large scale, same-sex intervention programs can help to achieve recommended PA regimens.
9.Cohort Profile: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort in Korea
Jee Seon SHIM ; Bo Mi SONG ; Jung Hyun LEE ; Seung Won LEE ; Ji Hye PARK ; Dong Phil CHOI ; Myung Ha LEE ; Kyoung Hwa HA ; Dae Jung KIM ; Sungha PARK ; Won Woo LEE ; Yoosik YOUM ; Eui Cheol SHIN ; Hyeon Chang KIM
Yonsei Medical Journal 2019;60(8):804-810
Mortalities from cardiovascular disease in Korea have decreased markedly over the past three decades. The major cardiovascular and metabolic risk factors, however, remain prevalent, and their burden on health is large. The Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) planned a cohort study in order to identify novel risk factors and to develop evidence-based prevention strategies of cardiovascular and metabolic diseases. The CMERC deliberately designed two prospective cohorts, a community-based general population cohort (the CMERC cohort) and its sister cohort (a hospital-based high-risk patient cohort), covering a broad spectrum of cardiovascular and metabolic diseases. This paper describes the CMERC cohort study of community-dwelling adults aged 30 to 64 years. A total of 8097 adults completed baseline measurement between 2013 and 2018. Baseline measurements assessed socio-demographic factors, medical history, health-related behaviors, psychological health, social network and support, anthropometry, body composition, and resting blood pressure and comprised electrocardiography, carotid artery ultrasonography, fasting blood analysis, and urinalysis. Both active follow-up through an annual telephone survey and a 5-year on-site health examination survey and passive follow-up through secondary data linkage with national databases, such as national death records, have been applied. Researchers interested in collaborative research may contact the corresponding author.
Adult
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Anthropometry
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Blood Pressure
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Body Composition
;
Cardiovascular Diseases
;
Carotid Arteries
;
Cohort Studies
;
Death Certificates
;
Electrocardiography
;
Fasting
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Follow-Up Studies
;
Humans
;
Information Storage and Retrieval
;
Korea
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Metabolic Diseases
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Mortality
;
Prospective Studies
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Republic of Korea
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Risk Factors
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Siblings
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Telephone
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Ultrasonography
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Urinalysis
10.Erratum: Is the Relationship between Depression and C Reactive Protein Level Moderated by Social Support in Elderly?-Korean Social Life, Health, and Aging Project (KSHAP)
Nam Wook HUR ; Hyeon Chang KIM ; Linda WAITE ; Yoosik YOUM
Psychiatry Investigation 2019;16(8):631-631
The acknowledgements was incorrect in the original publication of this article.

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