1.Risk Factors of FEV 1 /FVC Decline in COPD Patients
Na Young KIM ; Deog Kyeom KIM ; Shinhee PARK ; Yong Il HWANG ; Hyewon SEO ; Dongil PARK ; Seoung Ju PARK ; Jin Hwa LEE ; Kwang Ha YOO ; Hyun Woo LEE
Journal of Korean Medical Science 2025;40(6):e32-
Background:
Factors influencing the decline in forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC) for chronic obstructive pulmonary disease (COPD) progression remain uncertain. We aimed to identify risk factors associated with rapid FEV1 / FVC decline in patients with COPD.
Methods:
This multi-center observational study was conducted from January 2012 to December 2022. Eligible patients were monitored with symptoms, spirometric tests, and treatment patterns over 3 years. Rapid FEV1 /FVC decliners were defined as the quartile of patients exhibiting the highest annualized percentage decline in FEV1 /FVC.
Results:
Among 1,725 patients, 435 exhibited rapid FEV1 /FVC decline, with an annual change of −2.5%p (interquartile range, −3.5 to −2.0). Rapid FEV1 /FVC decliners exhibited lower body mass index (BMI), higher smoking rates, elevated post-bronchodilator (BD) FEV1 , higher post-BD FEV1 / FVC, and a lower prevalence of Staging of Airflow Obstruction by Ratio (STAR) stage IV. Rapid FEV1 /FVC decline was not linked to the annual exacerbation rate, but there was an association with symptom deterioration and FEV1 decline. In multivariable analyses, low BMI, current smoking, increased modified Medical Research Council dyspnoea score, low post-BD FEV1 , low STAR stage, high forced mid-expiratory flow (FEF 25-75% ), accelerated FEV1 decline, and not initiating dual BD therapy were identified as independent risk factors for rapid FEV1 /FVC decline.
Conclusion
We identified the risk factors for rapid FEV1 /FVC decline, including BMI, smoking, symptoms deterioration, FEV1 decline, and adherence to standard inhaler treatment. Our findings underscore the potential benefits of maintaining consistent use of long-acting beta-agonist/long-acting muscarinic antagonist even in the presence of worsening symptoms, in attenuating FEV1 /FVC decline.
2.Risk Factors of FEV 1 /FVC Decline in COPD Patients
Na Young KIM ; Deog Kyeom KIM ; Shinhee PARK ; Yong Il HWANG ; Hyewon SEO ; Dongil PARK ; Seoung Ju PARK ; Jin Hwa LEE ; Kwang Ha YOO ; Hyun Woo LEE
Journal of Korean Medical Science 2025;40(6):e32-
Background:
Factors influencing the decline in forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC) for chronic obstructive pulmonary disease (COPD) progression remain uncertain. We aimed to identify risk factors associated with rapid FEV1 / FVC decline in patients with COPD.
Methods:
This multi-center observational study was conducted from January 2012 to December 2022. Eligible patients were monitored with symptoms, spirometric tests, and treatment patterns over 3 years. Rapid FEV1 /FVC decliners were defined as the quartile of patients exhibiting the highest annualized percentage decline in FEV1 /FVC.
Results:
Among 1,725 patients, 435 exhibited rapid FEV1 /FVC decline, with an annual change of −2.5%p (interquartile range, −3.5 to −2.0). Rapid FEV1 /FVC decliners exhibited lower body mass index (BMI), higher smoking rates, elevated post-bronchodilator (BD) FEV1 , higher post-BD FEV1 / FVC, and a lower prevalence of Staging of Airflow Obstruction by Ratio (STAR) stage IV. Rapid FEV1 /FVC decline was not linked to the annual exacerbation rate, but there was an association with symptom deterioration and FEV1 decline. In multivariable analyses, low BMI, current smoking, increased modified Medical Research Council dyspnoea score, low post-BD FEV1 , low STAR stage, high forced mid-expiratory flow (FEF 25-75% ), accelerated FEV1 decline, and not initiating dual BD therapy were identified as independent risk factors for rapid FEV1 /FVC decline.
Conclusion
We identified the risk factors for rapid FEV1 /FVC decline, including BMI, smoking, symptoms deterioration, FEV1 decline, and adherence to standard inhaler treatment. Our findings underscore the potential benefits of maintaining consistent use of long-acting beta-agonist/long-acting muscarinic antagonist even in the presence of worsening symptoms, in attenuating FEV1 /FVC decline.
3.Risk Factors of FEV 1 /FVC Decline in COPD Patients
Na Young KIM ; Deog Kyeom KIM ; Shinhee PARK ; Yong Il HWANG ; Hyewon SEO ; Dongil PARK ; Seoung Ju PARK ; Jin Hwa LEE ; Kwang Ha YOO ; Hyun Woo LEE
Journal of Korean Medical Science 2025;40(6):e32-
Background:
Factors influencing the decline in forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC) for chronic obstructive pulmonary disease (COPD) progression remain uncertain. We aimed to identify risk factors associated with rapid FEV1 / FVC decline in patients with COPD.
Methods:
This multi-center observational study was conducted from January 2012 to December 2022. Eligible patients were monitored with symptoms, spirometric tests, and treatment patterns over 3 years. Rapid FEV1 /FVC decliners were defined as the quartile of patients exhibiting the highest annualized percentage decline in FEV1 /FVC.
Results:
Among 1,725 patients, 435 exhibited rapid FEV1 /FVC decline, with an annual change of −2.5%p (interquartile range, −3.5 to −2.0). Rapid FEV1 /FVC decliners exhibited lower body mass index (BMI), higher smoking rates, elevated post-bronchodilator (BD) FEV1 , higher post-BD FEV1 / FVC, and a lower prevalence of Staging of Airflow Obstruction by Ratio (STAR) stage IV. Rapid FEV1 /FVC decline was not linked to the annual exacerbation rate, but there was an association with symptom deterioration and FEV1 decline. In multivariable analyses, low BMI, current smoking, increased modified Medical Research Council dyspnoea score, low post-BD FEV1 , low STAR stage, high forced mid-expiratory flow (FEF 25-75% ), accelerated FEV1 decline, and not initiating dual BD therapy were identified as independent risk factors for rapid FEV1 /FVC decline.
Conclusion
We identified the risk factors for rapid FEV1 /FVC decline, including BMI, smoking, symptoms deterioration, FEV1 decline, and adherence to standard inhaler treatment. Our findings underscore the potential benefits of maintaining consistent use of long-acting beta-agonist/long-acting muscarinic antagonist even in the presence of worsening symptoms, in attenuating FEV1 /FVC decline.
4.Risk Factors of FEV 1 /FVC Decline in COPD Patients
Na Young KIM ; Deog Kyeom KIM ; Shinhee PARK ; Yong Il HWANG ; Hyewon SEO ; Dongil PARK ; Seoung Ju PARK ; Jin Hwa LEE ; Kwang Ha YOO ; Hyun Woo LEE
Journal of Korean Medical Science 2025;40(6):e32-
Background:
Factors influencing the decline in forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC) for chronic obstructive pulmonary disease (COPD) progression remain uncertain. We aimed to identify risk factors associated with rapid FEV1 / FVC decline in patients with COPD.
Methods:
This multi-center observational study was conducted from January 2012 to December 2022. Eligible patients were monitored with symptoms, spirometric tests, and treatment patterns over 3 years. Rapid FEV1 /FVC decliners were defined as the quartile of patients exhibiting the highest annualized percentage decline in FEV1 /FVC.
Results:
Among 1,725 patients, 435 exhibited rapid FEV1 /FVC decline, with an annual change of −2.5%p (interquartile range, −3.5 to −2.0). Rapid FEV1 /FVC decliners exhibited lower body mass index (BMI), higher smoking rates, elevated post-bronchodilator (BD) FEV1 , higher post-BD FEV1 / FVC, and a lower prevalence of Staging of Airflow Obstruction by Ratio (STAR) stage IV. Rapid FEV1 /FVC decline was not linked to the annual exacerbation rate, but there was an association with symptom deterioration and FEV1 decline. In multivariable analyses, low BMI, current smoking, increased modified Medical Research Council dyspnoea score, low post-BD FEV1 , low STAR stage, high forced mid-expiratory flow (FEF 25-75% ), accelerated FEV1 decline, and not initiating dual BD therapy were identified as independent risk factors for rapid FEV1 /FVC decline.
Conclusion
We identified the risk factors for rapid FEV1 /FVC decline, including BMI, smoking, symptoms deterioration, FEV1 decline, and adherence to standard inhaler treatment. Our findings underscore the potential benefits of maintaining consistent use of long-acting beta-agonist/long-acting muscarinic antagonist even in the presence of worsening symptoms, in attenuating FEV1 /FVC decline.
5.Epidemiologic Trends and Socioeconomic Disparities of Ankylosing Spondylitis in South Korea:A Nationwide Population-Based Study, 2010–2021
Seoung Wan NAM ; Jihye LIM ; Dae Jin PARK ; Jun Young LEE ; Jae Hyun JUNG ; Dae Ryong KANG
Yonsei Medical Journal 2024;65(12):761-769
Purpose:
To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data.
Materials and Methods:
Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups.
Results:
The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities.
Conclusion
This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.
6.Epidemiologic Trends and Socioeconomic Disparities of Ankylosing Spondylitis in South Korea:A Nationwide Population-Based Study, 2010–2021
Seoung Wan NAM ; Jihye LIM ; Dae Jin PARK ; Jun Young LEE ; Jae Hyun JUNG ; Dae Ryong KANG
Yonsei Medical Journal 2024;65(12):761-769
Purpose:
To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data.
Materials and Methods:
Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups.
Results:
The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities.
Conclusion
This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.
7.Epidemiologic Trends and Socioeconomic Disparities of Ankylosing Spondylitis in South Korea:A Nationwide Population-Based Study, 2010–2021
Seoung Wan NAM ; Jihye LIM ; Dae Jin PARK ; Jun Young LEE ; Jae Hyun JUNG ; Dae Ryong KANG
Yonsei Medical Journal 2024;65(12):761-769
Purpose:
To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data.
Materials and Methods:
Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups.
Results:
The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities.
Conclusion
This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.
8.Epidemiologic Trends and Socioeconomic Disparities of Ankylosing Spondylitis in South Korea:A Nationwide Population-Based Study, 2010–2021
Seoung Wan NAM ; Jihye LIM ; Dae Jin PARK ; Jun Young LEE ; Jae Hyun JUNG ; Dae Ryong KANG
Yonsei Medical Journal 2024;65(12):761-769
Purpose:
To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data.
Materials and Methods:
Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups.
Results:
The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities.
Conclusion
This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.
9.Epidemiologic Trends and Socioeconomic Disparities of Ankylosing Spondylitis in South Korea:A Nationwide Population-Based Study, 2010–2021
Seoung Wan NAM ; Jihye LIM ; Dae Jin PARK ; Jun Young LEE ; Jae Hyun JUNG ; Dae Ryong KANG
Yonsei Medical Journal 2024;65(12):761-769
Purpose:
To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data.
Materials and Methods:
Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups.
Results:
The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities.
Conclusion
This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.
10.A 4-Year Observation of the Incidence of Depressionand Suicide Among Older Adults from the Onset of theCOVID-19
Seoung-Kyun LEE ; Bo-Hyun YOON ; Kyungmin KIM ; Ha-Ran JUNG ; Hangoeunbi KANG ; Yuran JEONG ; Hyunju YUN ; Jye-Heon SONG ; Young-Hwa SEA ; Suhee PARK
Mood and Emotion 2023;21(3):51-60
Background:
This study aimed to examine the influence of the coronavirus disease pandemic 2019 (COVID-19) by comparing the incidences of depression, suicidal ideation, and suicidal attempts before and after the outbreak of the pandemic among community-dwelling older adults.
Methods:
In total, 9,784 older adults were recruited from 22 counties in Jeollanam-do between 2019 and 2022. Selfreported questionnaires, including sociodemographic factors, suicidal ideation, suicidal attempt, and Geriatric Depression Scale-Short Form Korean version, were used.
Results:
The proportion of the depression high-risk group tended to increase since the COVID-19 outbreak, increasing to 16.3%, 23.1%, and 25.7% in 2019, 2020, and 2021, respectively; however, decreased to 21.8% in 2022. The incidence of suicidal ideation showed a similar pattern. The incidence of suicidal attempts showed a different pattern, rising to 1.3% and 2.6% in 2019 and 2020, respectively and then falling to 1.1% and 0.8% in 2021 and 2022, respectively.
Conclusion
This study examined community-dwelling older adults and their mental states during the COVID-19 pandemic, and found that the risk of depression among older adults increased 1.708-fold in 2020, 1.877-fold in 2021, and 1.599-fold in 2022 compared to that in 2019, the year before the pandemic. Similarly, the risk of suicidal ideation increased by 1.582-fold in 2020, 1.913-fold in 2021, and 1.623-fold in 2022 compared with 2019 data. As the pandemic extended, mental health states improved; however, not to prepandemic levels. Suggesting that older people need continued support to alleviate the negative effects of the COVID-19 pandemic.

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