Objectives: This study aimed to examine the association between anticholinergic burden, cognitive function, and clinical severity in elderly patients with schizophrenia to suggest safer medication treatment strategies. Methods: A cross-sectional study was conducted with 60 patients aged 60-90 years diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria at the National Center for Mental Health. Participants with Clinical Global Impression-Severity (CGS-S) scores ≤4 were included. The Korean Version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment Packet, the 2nd Edition (CERAD-K), CGI-S, and total Anticholinergic Cognitive Burden (ACB) scores were assessed. Statistical analyses included Mann-Whitney tests, Bootstrap analysis of covariance, and Spearman correlations. Results: The mean age was 69.52±6.33 years, with 66.67% female participants. The mean total ACB score was 4.30±2.42, with 80% of patients having scores ≥3. High ACB group (n=48) showed significantly higher CGI-S scores (3.13±0.73 vs. 2.67±0.49, p=0.030) and lower performance in Word List Memory, Constructional Praxis, and Constructional Recall domains. After adjusting for education year, age, and sex, high ACB group showed significantly lower CERAD-K total score I than the low ACB group (F=5.947, p=0.018). Total ACB score also showed significant negative correlations with CERAD-K total score I (r=-0.32, p=0.011). Conclusion High anticholinergic burden in elderly schizophrenia patients was significantly associated with cognitive impairment and symptom severity. These findings suggest the need for careful medication adjustment in this population.

BACKGROUND/OBJECTIVES: This study examined factors associated with vegetarian orientation among adults in Seoul, with a focus on food literacy (FL) and sociodemographic characteristics. SUBJECTS/METHODS: A cross-sectional analysis was conducted using data from the 2023 Seoul Food Survey in Seoul, South Korea. The study included 3,592 adults aged ≥ 18 yrs, who were categorized into vegan, lacto-ovo vegetarian, pollo-pesco vegetarian, flexitarian, and omnivore groups. FL was assessed using a 33-item scale covering 3 domains: nutritional and safety, cultural and relational, and socioecological. Descriptive statistics, general linear models, and logistic regression analyses were performed. RESULTS: Among the participants, 16.0% followed a vegetarian-oriented diet, with flexitarians comprising the largest subgroup (10.9%). Vegetarian orientation was positively associated with being female (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.05–1.90), age of ≥ 65 yrs (OR, 2.51; 95% CI, 1.50–4.21) and having a college education (OR, 2.51;95% CI, 1.78–3.53). Negative associations were found for higher household income (≥ 5 million KRW/month) (OR, 0.63; 95% CI, 0.47–0.85) and low food security (OR, 0.33; 95% CI, 0.24–0.44). Vegetarian-oriented individuals had higher FL scores, particularly in the socioecological domain. In the multivariable models, higher FL scores remained significantly associated with vegetarian orientation. Health management (63.8%) was the most commonly reported motivation. CONCLUSION Gender, age, educational level and FL in the socioecological domain were significantly associated with vegetarian orientation. Our study findings underscore the need for policies and programs that promote sustainable diets tailored to specific sociodemographic groups with varying FL levels.

Background: With the aging population and advancements in medical care worldwide, the number of older patients with end-stage kidney disease continues to rise. This study aimed to identify factors associated with osteoporosis and osteopenia in older patients undergoing incident hemodialysis and assess their impact on mortality. Methods: We analyzed a large multicenter retrospective cohort of patients aged ≥70 years undergoing incident hemodialysis to identify factors associated with osteoporosis using logistic regression analysis and to assess the association of death with osteoporosis and osteopenia using Cox multivariable analysis. Results: Among 710 patients, 39.0% and 19.6% had osteoporosis and osteopenia, respectively. Osteoporosis was significantly associated with female sex, a history of fractures, and the absence of phosphate binder use. During a median follow-up of 36.8 months, 348 participants (58.8%) died. Mortality rates were the highest in the osteoporosis group (79.8%), followed by the osteopenia (77.2%) and normal bone mineral density (BMD) groups (35.2%). Cox regression analysis revealed that even after adjusting for covariates, the osteoporosis group was significantly associated with a higher mortality risk than the normal BMD group. Osteoporosis at the start of hemodialysis was significantly associated with higher mortality. Conclusion We should consider the importance of bone health in patients undergoing incident hemodialysis and pay attention to the use of phosphate binders and fracture prevention.

Background: Obesity is a well-known risk factor for chronic kidney disease and its progression. However, the impact of obesity on the renal function of the elderly population is uncertain. We investigated the association between obesity and renal outcomes in the elderly. Methods: We analyzed 130,504 participants from the Korean National Health Insurance Service-Senior cohort. Obesity was classified according to body mass index (BMI), sex-specific waist circumference (WC), and the presence of metabolic syndrome. The primary outcome was renal function decline, defined as a decline in the estimated glomerular filtration rate (eGFR) of at least 50% from baseline or new-onset end-stage renal disease. Results: During a follow-up period of 559,531.1 person-years (median, 4.3 years), 2,486 participants (19.0%; incidence rate of 4.44 per 1,000 person-years) showed renal function decline. A multivariate Cox proportional hazards model revealed that BMI/WC was not associated with renal function decline. However, the group with metabolic syndrome had a significantly increased risk of renal function decline compared to the group without metabolic syndrome (adjusted hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.13–1.36). Compared with the non-metabolic syndrome group, the adjusted HRs (95% CI) for participants with one through five components were 0.96 (0.84–1.11), 1.10 (0.96–1.27), 1.24 (1.06–1.45), 1.37 (1.12–1.66), and 1.99 (1.42–2.79), respectively (p for trend < 0.001). Conclusion In elderly Korean adults, metabolic syndrome and the number of its components were associated with a higher risk of renal function decline, but BMI or WC was not significant.

Objectives: This study aimed to develop a NOVA-based scoring approach for evaluating ultra- processed food (UPF) intake among Korean adults and to examine its performance. Previous studies have reported that young adults have the highest levels of UPF consumption. Accordingly, this study focused on adults aged 19–40 years and developed scoring components reflecting dietary patterns specific to Korean eating habits. Methods: Using 24-hour dietary recall data from adults aged 19–40 years in the Korea National Health and Nutrition Examination Survey (2021–2023), foods were classified according to the Korean-adapted NOVA system. The top 10 food groups accounting for ≥ 80% of cumulative UPF-derived energy were selected to construct the scoring components. The tool was operationalized using food frequency questionnaire (FFQ) data from the Gangwon cohort study (2022–2024). Intake frequencies were converted into scores ranging from 0 (“rarely or never”) to 5 (“≥ 1 time/day”), and summed to generate the NOVA–UPF score (range: 0–50). Results: Among 237 young adults (aged 20–49 years), the mean NOVA–UPF score was 22.9 ± 8.3. A positive association was observed between the NOVA–UPF score and FFQbased UPF energy intake (Spearman’s ρ = 0.629, P < 0.001). Cross-classification showed that 51.9% were classified into the same tertile and 94.9% into the same or adjacent tertiles, with a weighted kappa coefficient of 0.279. Conclusion This NOVA-based scoring approach may serve as a preliminary tool for assessing UPF intake in Korean young adults. Further refinement and rigorous validation using quantitative dietary assessment methods and more diverse populations are required before broader application.

BACKGROUND/OBJECTIVES: Particulate matter 2.5 (PM2.5) exposure can promote epithelialmesenchymal transition (EMT) in human retinal pigment epithelial (RPE) cells. The flowers of Tagetes erecta Linn, commonly known as marigold, are rich in diverse flavonoids and carotenoids and play a significant role in preventing cellular damage induced by oxidative stress, but the role of their extracts in RPE cells has not been reported. This study aimed to evaluate the influence of an ethanol extract of T. erecta Linn flower (TE) on PM2.5-induced EMT processes in RPE ARPE-19 cells.MATERIALS/METHODS: To investigate the protective effect of TE against ARPE-19 cell damage following PM2.5 treatment, cells were exposed to TE for 1 h before exposure to PM2.5 for 24 h. We investigated whether the efficacy of TE on suppressing PM2.5-induced EMT was related to antioxidant activity and the effect on the expression changes of factors involved in EMT regulation. Additionally, we further explored the role of intracellular signaling pathways associated with EMT inhibition. RESULTS: TE significantly blocked PM2.5-induced cytotoxicity while effectively preventing mitochondrial dysfunction, increased reactive oxygen species (ROS) generation, and mitochondrial membrane potential disruption. TE inhibited PM2.5-induced EMT and inflammatory response by suppressing the ROS-mediated transforming growth factor-β/ suppressor of mothers against decapentaplegic/mitogen-activated protein kinases signaling pathway. CONCLUSION Our results suggest that marigold extract is a highly effective in protection against PM2.5-induced eye damage.

BACKGROUND/OBJECTIVES: Particulate matter 2.5 (PM2.5) exposure can promote epithelialmesenchymal transition (EMT) in human retinal pigment epithelial (RPE) cells. The flowers of Tagetes erecta Linn, commonly known as marigold, are rich in diverse flavonoids and carotenoids and play a significant role in preventing cellular damage induced by oxidative stress, but the role of their extracts in RPE cells has not been reported. This study aimed to evaluate the influence of an ethanol extract of T. erecta Linn flower (TE) on PM2.5-induced EMT processes in RPE ARPE-19 cells.MATERIALS/METHODS: To investigate the protective effect of TE against ARPE-19 cell damage following PM2.5 treatment, cells were exposed to TE for 1 h before exposure to PM2.5 for 24 h. We investigated whether the efficacy of TE on suppressing PM2.5-induced EMT was related to antioxidant activity and the effect on the expression changes of factors involved in EMT regulation. Additionally, we further explored the role of intracellular signaling pathways associated with EMT inhibition. RESULTS: TE significantly blocked PM2.5-induced cytotoxicity while effectively preventing mitochondrial dysfunction, increased reactive oxygen species (ROS) generation, and mitochondrial membrane potential disruption. TE inhibited PM2.5-induced EMT and inflammatory response by suppressing the ROS-mediated transforming growth factor-β/ suppressor of mothers against decapentaplegic/mitogen-activated protein kinases signaling pathway. CONCLUSION Our results suggest that marigold extract is a highly effective in protection against PM2.5-induced eye damage.