Soong-Nang Jang

Effectiveness of Aquatic Exercise for Obese Patients with Knee Osteoarthritis: A Randomized Controlled Trial

To design an aquatic exercise (AQE) and land‐based exercise (LBE) program to enhance knee function and reduce body fat in patients with obesity and knee osteoarthritis and to investigate the effectiveness of AQE and LBE on body fat, functional fitness, and functional status.

Relationship between muscle mass and physical performance: is it the same in older adults with weak muscle strength?

BACKGROUND the relationship between muscle mass and physical performance has not been consistent among studies. OBJECTIVE to clarify the relationship between muscle mass and physical performance in older adults with weak muscle strength. DESIGN cross-sectional analysis using the baseline data of 542 older men and women from the Korean Longitudinal Study on Health and Aging. METHODS dual X-ray absorptiometry, isokinetic dynamometer and the Short Physical Performance Battery (SPPB) were performed. Two muscle mass parameters, appendicular skeletal mass divided by weight (ASM/Wt) and by height squared (ASM/Ht(2)), were measured. We divided the participants into a lower-quartile (L25) group and an upper-three-quartiles (H75) group based on the knee-extensor peak torque. Correlation analysis and logistic regression models were used to assess the association between muscle mass and low physical performance, defined as SPPB scores <9, after controlling for confounders. RESULTS in the L25 group, no correlation between mass and SPPB was detected, whereas the correlation between peak torque and SPPB was significant and higher than that in the H75 group. Results from the logistic models also showed no association between muscle mass and SPPB in the L25 group, whereas muscle mass was associated with SPPB in the H75 group. CONCLUSION muscle mass was not associated with physical performance in weak older adults. Measures of muscle strength may be of greater clinical importance in weak older adults than is muscle mass per se.

Muscle strength is the main associated factor of physical performance in older adults with knee osteoarthritis regardless of radiographic severity

The aim of the study is to compare factors associated with physical performance in older individuals with severe knee osteoarthritis and those with less-severe osteoarthritis. This is an ancillary cross-sectional study to a population-based cohort study focusing on Koreans age 65 years or older. The analysis included 553 subjects with information about knee pain, depressive symptoms, and comorbidities collected by self-reported questionnaire, and body weight, knee osteoarthritis severity, muscle strength, and physical measures by observer-rated tests. Stepwise logistic regression analyses were performed with physical performance as an outcome variable and the others as independent variables across radiographic knee osteoarthritis severity. In the minimal-to-moderate-severity group, muscle strength, knee pain, BMI, and age were related to poor performance (OR [CI] 0.81 [0.73-0.90], 1.12 [1.03-1.21], 0.87 [0.79-0.96], and 1.09 [1.05-1.14], respectively). In the severe group, muscle strength was the only factor significantly associated with poor performance (OR [CI] 0.72 [0.58-0.89]). Muscle strength, knee pain, and BMI were important determinants of physical performance in the older population with knee osteoarthritis. In severe knee osteoarthritis patients, muscle strength was the only significant determinant.

Waist circumference, not body mass index, is associated with renal function decline in korean population: hallym aging study.

Background Prospective investigation of obesity and renal function decline in Asia is sparse. We examined the associations of body mass index (BMI) and waist circumference (WC) with renal function decline in a prospective study of Korean population. Methods A total of 454 participants who had baseline estimated glomerular filtration rate (eGFR) levels of more than 60 mL/min/1.73 m2 in Hallym Aging Study (HAS) were included and followed for 6 years. Renal function decline was defined as follows: (1) an eGFR decline ≥3 mL/min/1.73 m2/year (n = 82 cases); (2) an eGFR decrease of 20% or greater (n = 87 cases) at follow-up; (3) an eGFR decrease of 20% greater at follow-up or eGFR decline ≥3 mL/min/1.73 m2/year (n = 91 cases); and (4) an eGFR <60 mL/min/1.73 m2 at follow-up (n = 54 cases). eGFR was determined based on the Modification of Diet in Renal Disease (MDRD) Study equation. Multivariate logistic regression model was used to determine the association between obesity and renal function decline. Results We found that central obesity was associated with faster renal function decline. Comparing WC of >95 cm in men or >90 cm in women with ≤90 cm in men or ≤85 cm in women, ORs (95% CIs) ranged from 2.31 (1.14–4.69) to 2.78 (1.19–6.50) for the 4 definitions of renal function decline (all p-values for trend <0.05). Waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) also was associated with renal function decline. There was no significant association of BMI with renal function decline. Conclusions Central obesity, but not BMI, is associated with faster renal function decline in Korean population. Our results provide important evidence that simple measurement of central fat deposition rather than BMI could predict decline in renal function in Korean population.

Association between exercise and fear of falling in community-dwelling elderly koreans: results of a cross-sectional public opinion survey

OBJECTIVE To investigate the association between habitual exercise and fear of falling in an older Korean population. DESIGN Cross-sectional study conducted in a population-based sample of an urban city. SETTING Urban city in South Korea. PARTICIPANTS Randomly sampled older Korean people (N=828; aged ≥65y) living in a typical urban city located in South Korea. INTERVENTION Standardized telephone interview. MAIN OUTCOME MEASURES Data on exercise habits, history of falls during the previous year, and fear of falling were obtained using a random digit dialing telephone survey method. Multiple linear regression and multiple logistic regression analyses were used to examine the association between exercise habits and the fear of falling. RESULTS The incidence of falls in the study cohort was 13%, and the prevalence of the fear of falling was 67.4% (47.6% in men and 80.8% in women). About 30% of those that expressed a fear of falling stated that this was the cause of their limited activity. Older men and women who exercised regularly showed a similar level of fear of falling, but they were less likely to experience fear-related activity restriction than nonexercisers. CONCLUSIONS A regular exercise habit was found to be inversely associated with fear-related activity restriction regardless of fall experience among older Korean men and women.

Health Conditions Sensitive to Retirement and Job Loss Among Korean Middle-aged and Older Adults

Objectives This study was conducted to examine the association between health condition and leaving the labor market among middle-aged and older adults in South Korea. Methods Data was obtained from individuals aged 45 years and older participating in the 2006 and 2008 Korean Longitudinal Study of Ageing. We used various health measures including chronic diseases, comorbidities, traffic accident injuries, disabilit of instrumental activities of daily living, depressive symptoms, and self-rated health. The odds ratios of job loss, and retirement, versus employment were calculated using multinomial logistic regression by each health measure. Results In our cross-sectional and longitudinal analysis, health problems related to physical disabilities had the greatest effect on leaving the worksite. A shift in health condition from good to poor in a short period was a predictor of increased risk of unemployment but a persistent pattern of health problems was not associated with unemployment. Women with health problems showed a high probability of retirement, whereas among men, health problems instantly the possibility of both job loss and retirement. Conclusions Health problems of middle aged and older workers were crucial risk factors for retirement and involuntarily job loss. Especially functional defect and recent health problems strongly and instanty affected employment status.

Incidence and related factors of traffic accidents among the older population in a rapidly aging society

OBJECTIVE To estimate the incidence of traffic accidents and find related factors among the older population. METHODS We used the cross-sectional data from the Korean Community Health Survey (KCHS), which was conducted between 2008 and 2010 and completed by 680,202 adults aged 19 years or more. And we used individuals aged 60 years or above (n=210,914). The incidence of traffic accidents was estimated as number of traffic accidents experienced per thousand per year by a number of factors including age, sex, residential area, education, employment status, and diagnosis with chronic diseases. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each potential risk factor adjusted for the others. RESULTS Incidence of traffic accidents was estimated as 11.74/1,000 per year for men, and 7.65/1,000 per year for women. It tended to decline as age increased among women; compared to the youngest old age group (60-64), the older old groups (70-74 and 80+) were at lower risk for traffic accidents. Depressive symptom was the strongest predictor for both men (OR=1.83, 95% CI=1.28-2.61) and women (1.70, 1.23-2.35). Risk of traffic accident was greater in employed men (1.76, 1.40-2.22) and women diagnosis with arthritis (1.36, 1.06-1.75). CONCLUSION Given that the incidence of and factors associated with traffic accidents differ between men and women, preventive strategies, such as driver education and traffic safety counseling for older adults, should be modified in accordance with these differences.

Self-reported anthropometric information cannot vouch for the accurate assessment of obesity prevalence in populations of middle-aged and older Korean individuals

While there are strong correlations between self-reported and directly measured anthropometric data, the discrepancy and systematic errors associated with these, particularly among middle-aged and older persons residing in South Korea, remain a contentious issue. All participants were selected from the Korean Longitudinal Study of Aging (KLoSA), a panel study conducted by the Korea Labor Institute; data from 510 participants (290 females; 56.9%) were analyzed. We considered general characteristics, including sex, age, education, marital status, employment, income, and residential region, and used self-rated health (SRH) as a generic indicator of health status. One-way ANOVA, t-test, and Scheffés test (α=0.1) were employed to explore the difference between directly measured and self-reported values. Sensitivity and specificity values were used to assess the validity of obesity diagnoses based on self-reported body mass index (BMI: body weight in kilograms divided by the square of height in meters). The means of BMI differences were 1.3 (±1.2)kg/m(2) among men and 1.8 (±1.5)kg/m(2) among women. In men, the difference could be attributed to measured BMI and residential region; among women, age and education level influenced the discrepancy in BMI. Scheffés test (α=0.1) for multiple comparisons of group means revealed that women over the age of 65 years, with lower than middle-school education, who lived in rural areas, and had a measured BMI of 25kg/m(2) or more, were more likely to have significant BMI discrepancies. In contrast, for men, significant predictors were living in rural areas and being obese. Although adequate correlations were seen in self-reported BMI, they indicated low sensitivity, with 46.5% and 60.1% among males and females, respectively. However, specificities were very high, at 97.8% and 98.0% for males and females, respectively. The diagnostic performance of self-reported BMI is insufficient for assessing obesity prevalence among middle-aged or older Koreans.

Post-polio syndrome and risk factors in korean polio survivors: a baseline survey by telephone interview.

Objective To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors. Methods The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR). Results Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS. Conclusion We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS.

The Relationship Between Job Stress, Job Satisfaction, and the Symptom Checklist-90-Revision (SCL-90-R) in Marine Officers on Board

Objectives This study was conducted to investigate the relationships among job stress, job satisfaction, and mental health in marine officers. Methods The researchers gathered data on marine officers working at a harbor in Chungcheong Province, South Korea, using a self-reported questionnaire. Mental health was measured by the Symptom Checklist-90-Revision (SCL-90-R), and general characteristics including socioeconomic factors, job stress, and job satisfaction were measured by structured questionnaires. Multiple regression analysis was performed to investigate the relationships among job stress, job satisfaction, and mental health status according to the symptom dimensions of the SCL-90-R. Results Among the marine officers, obsessive-compulsive behavior, depression, and somatization were the most problematic symptoms. Those who reported poor health, low job satisfaction, and high job stress had a higher prevalence of psychoticism, somatization, depression, anxiety, and phobic anxiety. Conclusions An occupational health system should be introduced that would regularly check the mental health of marine officers in charge of ships and sailors, in order to help reduce their stress levels, enhance their job satisfaction, and thereby improve their mental health.