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ABSTRACT: OBJECTIVE: This study examined associations between changes in lifestyle risks and disability in late life. METHOD: A national sample of Koreans aged ≥65 years was surveyed at baseline (2006) and 2-year follow-up (n=3,511). Disability transition was categorized as disability-free, improved, maintained, and declined, based on activities of daily living (ADL) and instrumental ADL (IADL) scales. Lifestyle risk factors included current smoking, heavy alcohol consumption, low physical activity, and unhealthy weight. Changes in lifestyle risks were categorized as risk-free, positive (decreased risk), stable, and negative (increased risk). Multinomial logistic regression models examined the influence of changes in lifestyle risks on disability transition. RESULTS: A higher percentage (82.9%) of respondents who were risk-free remained disability-free than those who exhibited positive (71.8%), stable (64.9%), or negative (63.8%) change (p<0.001). Sustaining no lifestyle risks, compared with negative change, was associated with a higher likelihood of remaining disability-free than decline (odds ratio=2.68, 95% CI: 1.32-5.42), adjusting for covariates. Among individual lifestyle factors, physical activity was predictive of not only functional independence but also improvement and maintenance. CONCLUSION: Older adults adopting more healthy lifestyles are more likely to maintain functional independence than decline. Making healthy lifestyle choices may delay disability progression in later life.
Preventive Medicine 12/2012; · 3.22 Impact Factor
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ABSTRACT: Despite the predictive value of combined healthy lifestyles in maintaining physical and cognitive functioning in late life, little is known about the clustering patterns of healthy lifestyle behaviors in older people. The aim of the present study was to examine the prevalence, clustering and population characteristics of adherence to multiple health behaviors in community-dwelling older Korean adults.
The study population consisted of a nationally representative sample of 4165 Korean adults aged 65 years and older in 2006. Healthy lifestyles, defined as adherence to recommended guidelines, included non-smoking, no heavy drinking, physical activity and healthy weight. Combinations of behavioral patterns and prevalence odds ratios for pairwise clusters were analyzed. Multinomial logistic regression was used to identify demographic and health-related characteristics associated with the number of adherence to guideline recommendations.
Those who adhered to all four guideline recommendations constituted the minority (11.7%). More women than men engaged in a higher number of healthy lifestyles. Clustering was more pronounced in men for whom no heavy alcohol drinking and physical activity centered around non-smoking. In women, clustering patterns were less obvious. Men, those with low levels of education, income and wealth, and the functionally impaired were less likely to adhere to multiple healthy lifestyles.
Clustering of healthy lifestyles, especially among older men, supports the potential benefit of a multiple behavior change approach. Health promotion efforts should target the socially disadvantaged and functionally compromised segment of the older population presenting low adherence to recommended behaviors.
Geriatrics & Gerontology International 12/2011; 12(3):515-23.
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ABSTRACT: This study was to examine the association between frequency of legumes and soy products consumption and functional disability in older Korean women.
Cross-sectional study. Data came from the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Subjects were 562 women aged 65 years and older living in the community.
Frequency of legume consumption was obtained by using food frequency questionnaire and functional disability was assessed using the instrumental activities of daily living (IADL) and ADL scales. Poisson regression analyses were conducted to examine the association of frequency of legume and soy consumption with functional disability, controlling for covariates.
Dietary intake of legumes and soy products was associated with a significantly reduced risk of IADL disability after controlling for potential risk factors (p = 0.002 for trend). Compared with women who consumed legumes and soy products < 1 time per week, those who consumed ≥ 3 times per day had a reduced risk of IADL disability (prevalence ratio = 0.70; 95% confidence interval: 0.51-0.96). In contrast, legumes and soy products consumption was not significantly associated with ADL disability.
Frequent legumes and soy products consumption was inversely associated with IADL disability in older women. Further studies are needed to clarify the protective effect of legume consumption on functional disability in older people.
Maturitas 07/2011; 69(3):268-72. · 2.77 Impact Factor
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ABSTRACT: To investigate the multiple effects of socioeconomic factors on cognitive impairment in older persons.
Subjects were a nationally representative sample (n = 4,155) aged >or=65 years of the Korean Longitudinal Study of Aging. Cognitive status was assessed by the Mini-Mental State Examination. Education, income, wealth and occupation were measured, with low levels on each factor combined to produce an aggregate risk score. Multiple logistic regression was used to analyze the combined effects of socioeconomic risks on cognitive impairment.
A socioeconomic risk gradient was evident, with the combined effect being stronger than any one of the risk factors acting alone. Compared with those with no risks, the odds ratios were 2.4 (for 2 socioeconomic risks), 3.4 (3 risks) and 7.7 (4 risks) for men, and 2.8 (2 risks), 3.5 (3 risks) and 5.4 (4 risks) for women. For individual socioeconomic risks, income and occupation were significant predictors of cognitive impairment in men, whereas in women, all 4 factors were independently associated.
Multiple socioeconomic risks have a combined effect on cognitive impairment in older adults.
Dementia and Geriatric Cognitive Disorders 01/2010; 29(6):523-9. · 2.14 Impact Factor
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ABSTRACT: An increasing body of evidence suggests that health behaviors may protect against cognitive impairment and dementia. The purpose of this study was to summarize the current evidence on health behavioral factors predicting cognitive health through a systematic review of the published literature.
PubMed, Embase, and PsycINFO databases were searched for studies on community representative samples aged 65 and older, with prospective cohort design and multivariate analysis. The outcome--cognitive health--was defined as a continuum of cognitive function ranging from cognitive decline to impairment and dementia, and health behaviors included physical activity, smoking, alcohol drinking, body mass index, and diet and nutrition.
Of 12,105 abstracts identified, 690 relevant full-texts were reviewed. The final yield amounted to 115 articles of which 37 studies were chosen that met the highest standards of quality. Leisure time physical activity, even of moderate level, showed protective effects against dementia, whereas smoking elevated the risk of Alzheimer's disease. Moderate alcohol consumption tended to be protective against cognitive decline and dementia, but nondrinkers and frequent drinkers exhibited a higher risk for dementia and cognitive impairment. Midlife obesity had an adverse effect on cognitive function in later life. Analysis showed vegetable and fish consumption to be of benefit, whereas, persons consuming a diet high in saturated fat had an increased dementia risk.
The review demonstrates accumulating evidence supporting health behavioral effects in reducing the risk of cognitive decline and dementia. Results indicate potential benefits of healthy lifestyles in protecting cognitive health in later life.
International Psychogeriatrics 11/2009; 22(2):174-87. · 2.24 Impact Factor
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ABSTRACT: The increasing number of persons with dementia poses a serious threat to public health in an aging society. Efforts to curb the rising prevalence of dementia have directed attention to health promotion as a viable strategy for delaying dementia onset and maintaining cognitive function in later life. For the latter purpose, public recommendations were deve-loped based on a systematic review of the literature. Significant lifestyle variables found to predict cognitive function and dementia in later life were physical activity, non-smoking, social activity, cognitive activity, moderate alcohol con-sumption, normal body weight (BMI), and healthy nutrition and diet (fish, vegetables, fruits, vitamin C and E, etc.). Cogni-tive health recommendations were developed and named PASCAL, an acronym for (1) Physical activity, (2) Anti-smo-king, (3) Social activity, (4) Cognitive activity, (5) Alcohol drinking in moderation, and (6) Lean body mass and healthy diet. These recommendations can be used to educate the public and raise awareness in health professionals to the important role a healthy lifestyle plays in maintaining cognitive health in later life.
J Korean Geriatr Soc. 07/2009; 13(13):61-68.
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ABSTRACT: This study aimed to examine the influence of multiple lifestyle behaviors on cognitive function in older persons living in an urban community.
A representative sample of 977 persons aged 65 and older in Suwon, Korea were interviewed in 2001, with follow-up interviews completed on 645 (2002) and 537 (2003). Lifestyle behaviors included physical activity, non-smoking, vegetable consumption, and social activity. Individual, as well as, the number and combination of health behavioral profiles were considered. Cognitive function was assessed by the Korean version of the Mini-Mental State Examination. Linear regression with generalized estimating equations was used in the analysis, controlling for sociodemographics and chronic conditions.
All lifestyle behaviors showed independent association with cognitive ability, even after adjusting for the covariates. An incremental benefit of multiple lifestyle behaviors was evident, with those engaging in more positive behaviors exhibiting a tendency to have a higher cognitive score. A two- or three-factor combination of non-smoking, vegetable consumption, and social activity showed the strongest association with cognitive function.
Participation in healthy lifestyles may contribute to the maintenance of cognitive function in later life. It underlines the potential benefit of multiple behaviors in promoting cognitive health of older persons.
Preventive Medicine 12/2008; 48(1):86-90. · 3.22 Impact Factor
