Health Literacy and Health-Related Quality of Life in Older Adults With Mild Cognitive Impairment.

OBJECTIVES: Health literacy is considered crucial in health status outcomes, but little is known about the association among cognitively impaired persons. This study investigated the association between health literacy and health-related quality of life (HRQoL) in older adults with mild cognitive impairment (MCI). We further examined whether the association between health literacy and HRQoL depends on age, sex, and educational attainment. DESIGN: A cross-sectional study was conducted between January and December 2022. SETTING AND PARTICIPANTS: The study population was 233 older adults with MCI who visited the Veterans Health Service Medical Center in Korea. METHODS: The diagnosis of MCI was confirmed by a physician based on clinical and neuropsychological assessments. The European Health Literacy Survey Questionnaire and EuroQol Five Dimensions Questionnaire were used to measure the health literacy and HRQoL of the participants. RESULTS: HRQoL was significantly correlated with health literacy (r = 0.25, P ≤ .001) and its 3 subdomains (r = 0.27, P ≤ .001 for health care; r = 0.19, P = .004 for disease prevention; and r = 0.18, P = .005 for health promotion). After adjustment for potential covariates, older adults with higher levels of health literacy were significantly associated with better HRQoL: ß = 0.02 (P = .0021) for health literacy, ß = 0.07 (P = .0001) for health care, and ß = 0.04 (P = .0443) for disease prevention. The interactions between HRQoL and health literacy with the specific variables of age, sex, and education demonstrated a statistical significance (ß = 0.02 with age, ß = 0.03 with sex, and ß = 0.06 with education). CONCLUSIONS AND IMPLICATIONS: There was a significant association between health literacy and HRQoL among older adults with MCI. This finding suggests that improving health literacy of older adults with MCI may enhance HRQoL. An education intervention is recommended to reduce the existing health disparities due to low health literacy.

Spatiotemporal variability of the association between greenspace exposure and depression in older adults in South Korea.

BACKGROUND: A number of studies based on young to middle aged adult and child samples have found that exposure to greenspace and bluespace can have a positive impact on mental health and well-being. However, there is limited research among older adults and the extant studies have provided mixed results. The present study was designed to examine how the association between these forms of exposure and depressive symptoms among older adults varies as a function of different spatially and temporally resolved exposure metrics. METHODS: The sample consisted of 617 individuals (46.19% female) aged ≥ 60 years of age. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Individuals' greenspace exposure was quantified using spatially and temporally resolved metrics, including monthly and annual averaged satellite-derived normalized difference vegetation index (NDVI) across multiple buffer distances (250 m to 2,000 m) centered at participants' home address. We also quantified exposure to blue-greenspace from a highly detailed land use and land cover dataset. A multivariable logistic regression model assessed the association between greenspace and blue-greenspace exposure and depressive symptoms, adjusting for age, sex, income, education, marital status, current smoking, alcohol status, medical conditions, temperature, crime rate, population density, and per capita park area. RESULTS: We found a significant association between exposures to greenspace and blue-greenspace and depressive symptoms (CES-D cutoff ≥ 4) among older adults. After adjusting for confounding variables, the odds of depressive symptoms were significantly decreased by an IQR increment in residential exposure to greenspace [odds ratio (OR) = 0.67; 95% confidence interval (95% CI), 0.49 ~ 0.91] and blue-greenspace (OR = 0.59; 95% CI, 0.41 ~ 0.84) measured nearby their home address (i.e., as close as 250 m). When stratified by household income level, the association was only significant among low-income individuals. We also found temporal variation in the association between depressive symptoms and monthly NDVI-based greenspace exposure, in which the odds of depressive symptoms were the lowest for greenspace in cold months (i.e., January, February, and March). CONCLUSIONS: Our findings suggest that neighborhood greenspace may serve as a protective factor against depression among older adults, but the benefits may depend on the spatial and temporal context. More investigation is needed to replicate our findings on the spatial and temporal variations of greenspace exposure metrics and their effects on depressive symptoms.

Association between multiple jobs and physical and psychological symptoms among the Korean working population.

Background: The prevalence of multiple job-holding (MJH) is expected to show an upward trend among Korean workers, yet its potential impact on workers' health remains poorly discussed. This study aimed to explore the association between MJH and experience of physical and psychological symptoms in various aspects among active Korean workers and to identify its differences depending on workers' gender. Methods: We conducted a population-based cross-sectional study among South Korean workers aged 15-59 using data from the 6th Korean Working Conditions Survey. The final study sample comprised 34,175 participants. MJH status and symptoms, such as musculoskeletal pain, headache or eyestrain, fatigue, insomnia, and anxiety, were measured by self-reported data. Logistic regression analyses were performed on the total sample and gender-stratified groups, with adjustments for the sociodemographic and occupational characteristics of the participants. Results: One hundred thirty-five men and 103 women were defined as multiple job-holders (MJHers) among the study sample. When adjusted for sociodemographic and occupational characteristics, MJHers suffered more events of headache or eyestrain (odds ratio [OR]: 1.85, 95% confidence interval [CI]: 1.23-2.78) and anxiety (OR: 1.99, 95% CI: 1.05-3.79). Gender-stratified analyses with adjustment showed that among women workers, MJH was associated with musculoskeletal pain (OR: 1.85, 95% CI: 1.02-3.34), headache or eyestrain (OR: 2.53, 95% CI: 1.37-4.67), fatigue (OR: 2.38, 95% CI: 1.29-4.40), insomnia (OR: 1.92, 95% CI: 1.04-3.57), and anxiety (OR: 2.83, 95% CI: 1.11-7.20). Conclusions: We found a significant association between MJH and various symptoms. Women MJHers were revealed to be a more vulnerable population than their men counterparts. Further research should account for the social context of MJH, and appropriate monitoring and intervention for maintaining the well-being of MJHers are needed.

Telecommuting during the COVID-19: the role of job demand and control on health outcomes.

Background: The coronavirus disease 2019 (COVID-19) pandemic drastically modified the occupational system wherein telecommuting has risen as the major form of work. Few studies have incorporated Karasek's job demand-control (JDC) model into explaining the health effects of telecommuting. This study aimed to investigate the health risk in South Korean telecommuters during the pandemic, and its distribution according to the job stress-related factors. Methods: A nationwide population-based cross-sectional study of South Korean laborers was conducted, utilizing the 6th Korean Working Conditions Survey (2020-2021). Following the previously described concept of telecommuting, 14,478 white-collar employees were eligible study participants. Telecommuting, job demand, job control, and various health indicators were measured by the responses to the survey. Participants were stratified into 4 job profiles classified by the JDC model. We conducted multiple logistic regression analyses between telecommuting and health-related outcomes to estimate the odds ratio (OR) with a 95% confidence interval (CI). Results: One hundred forty-six low-strain, 223 active, 69 passive, and 148 high-strain workers were screened as telecommuters. Compared to office workers, telecommuters had a higher proportion in high job control groups. Subgroup analysis demonstrated different relationships between telecommuting and health, where only active telecommuters showed a higher prevalence of depression (OR: 1.980, 95% CI: 1.126-3.481), and high-strain telecommuters were affected in most outcomes including insomnia (OR: 2.555, 95% CI: 1.473-4.433), musculoskeletal pain (OR: 2.786, 95% CI: 1.719-4.517), headache/eye strain (OR: 3.074, 95% CI: 1.992-4.745) and presenteeism (OR: 1.932, 95% CI: 1.193-3.131). Conclusions: This study revealed significantly increased odds of multiple health outcomes among South Korean telecommuters during the COVID-19 pandemic era. High-strain job holders were prominently susceptible to the negative health impacts of telecommuting. Occupational health management towards telecommuters should approach mitigating high job demand and low job control.

Deficits of Facial Emotion Recognition in Elderly Individuals with Mild Cognitive Impairment.

INTRODUCTION: The study of facial emotion recognition is under-explored in subjects with mild cognitive impairment (MCI). We investigated whether deficits in facial emotion recognition are present in patients with MCI. We also analyzed the relationship between facial emotion recognition and different domains of cognitive function. METHODS: This study included 300 participants aged 60 years or older with cognitive decline. We evaluated 181 MCI and 119 non-MCI subjects using the Seoul Neuropsychological Screening Battery-Core (SNSB-C) and facial emotion recognition task using six facial expressions (anger, disgust, fear, happiness, sadness and surprise). A Generalized Linear Model (GLM) was used to assess the association between cognitive performance and accuracy of facial emotion recognition and to compare facial emotion recognition in the MCI group based on the impairment of five different domains of cognitive function. The model was adjusted for age, sex, years of education, and depressive symptoms. RESULTS: Patients with MCI had a lower score for accurately recognizing total facial emotion (0.48 vs. 0.53; ρ = 0.0003) and surprise (0.73 vs. 0.81; ρ = 0.0215) when compared to cognitively healthy subjects. We also discovered that frontal/executive function domain (Digit Symbol Coding [DSC, 0.38 vs. 0.49; p < 0.0001], Controlled Oral Word Association Test [COWAT, 0.42 vs. 0.49; p = 0.0001], Korean-Trail Making Test [K-TMT, 0.37 vs. 0.48; p = 0.0073], Korean-Color Word Stroop Test [K-CWST, 0.43 vs. 0.49; p = 0.0219]) and language domain (Korean-Boston Naming Test [S-K-BNT, 0.46 vs. 0.47; p = 0.003]) were statistically associated with the deficits of facial emotion recognition in patients with MCI. CONCLUSION: We observed a significant association between deficits in facial emotion recognition and cognitive impairment in elderly individuals.

Association between Multiple Trace Elements, Executive Function, and Cognitive Impairment with No Dementia in Older Adults.

Many studies suggest a significant association between individual essential trace elements (ETEs) and cognitive impairment in older adults, but evidence of the synchronized effect of multiple ETEs on cognitive function is lacking. We investigated the association between multiple ETEs, cognitive impairment with no dementia (CIND), and executive function in older Korean adults, using the Bayesian kernel machine regression (BKMR) model. Three hundred and thirty-six older adults were included as the study population and classified as the CIND and control groups. Blood manganese (Mn), copper (Cu), zinc (Zn), selenium (Se), and molybdenum (Mo) were measured as relevant ETEs. The frontal/executive tests included digit symbol coding (DSC), the Korean color word Stroop test (K-CWST), a controlled oral word association test (COWAT), and a trial-making test (TMT). Overall, the BKMR showed a negative association between multiple ETEs and the odds of CIND. Mn was designated as the most dominant element associated with the CIND (PIP = 0.6184), with a U-shaped relationship. Cu and Se levels were positively associated with the K-CWST percentiles (ß = 31.78; 95% CI: 13.51, 50.06) and DSC percentiles (ß = 25.10; 95% CI: 7.66, 42.53), respectively. Our results suggest that exposure to multiple ETEs may be linked to a protective mechanism against cognitive impairment in older adults.

Increased breast cancer incidence among nurses in a tertiary university hospital in South Korea.

Background: A series of breast cancer cases were recently reported in a tertiary university hospital in South Korea. Nurses are generally exposed to risk factors for breast cancer such as night shift work, antineoplastic agents, and job strain. However, the epidemiological evidence of excess incidence among nurses remains lacking. This study aims to investigate the excess incidence of breast cancer among nurses in a tertiary university hospital and provide epidemiological evidence of occupational risk factors. Methods: A retrospective cohort was developed using personnel records of female workers in the nursing department who worked from January 2011 to June 2021 in a tertiary university hospital in South Korea. Sick leave records were used to identify cases of breast cancer. The standardized incidence ratio of breast cancer among nurses was compared to the general population. Results: A total of 5,509 nurses were followed up for 30,404 person-years, and 26 breast cancer cases were identified. This study revealed a significantly increased breast cancer incidence among all included nurses, with a standardized incidence ratio of 1.65 (95% confidence interval [CI]: 1.08-2.41), compared to the general population. Workers, who handle antineoplastic agents in their representative department and current and/or former department, had significantly elevated breast cancer standardized incidence ratios of 2.73 (95% CI: 1.008-5.94) and 3.39 (95% CI: 1.46-6.68), respectively. Conclusions: This study provides significant evidence of increased breast cancer risk among nursing staff in a hospital setting, particularly those who handle antineoplastic drugs. Measures that reduce exposure to risk factors should be implemented, especially anticancer drugs, to protect healthcare professionals. Further research at a national level that focuses on healthcare workers is necessary to validate breast cancer incidence and its contributing factors.

Telecommuting-related health outcomes during the COVID-19 pandemic in South Korea: a national population-based cross-sectional study.

BACKGROUND: Telecommuting has expanded greatly during the COVID-19 pandemic. Since the advent of remote working from home, there has been an ongoing controversy about the positive or negative health-related impact of telecommuting. This study aimed to investigate change in the occupational health risk in South Korean workers involved in telecommuting during the pandemic period compared to daily commuters. METHODS: A population-based cross-sectional study of South Korean workers using the secondary data from the 6th Korean Working Conditions Survey (2020-2021) was designed. A total of 12,354 white-collar wage employees were selected as the study sample. Telecommuting, depression, anxiety, insomnia, fatigue, musculoskeletal pain, headache-eye strain, absenteeism, and presenteeism were measured by self-reported data. Multiple logistic regression models, including gender stratification analysis, were used to estimate the adjusted odds ratio (AOR) with a 95% confidence interval (CI) for the health outcomes of telecommuters. RESULTS: Among the study population, 338 males and 318 females were reported to be telecommuters. The entirely adjusted regression model showed a positive association between telecommuting and anxiety (AOR = 2.82; 95% CI, 1.93-4.10), insomnia (AOR = 1.93; 95% CI, 1.27-2.92), fatigue (AOR = 1.76; 95% CI, 1.30-2.37), musculoskeletal pain (AOR = 1,76; 95% CI, 1.33-2.32), headache-eye strain (AOR = 1.94; 95% CI, 1.48-2.54), presenteeism (AOR = 1.66; 95% CI, 1.20-2.28) respectively. Gender difference was identified in that only female telecommuters had a higher risk of depression (AOR = 1.62; 95% CI, 1.04-2.53) and insomnia (AOR = 2.07; 95% CI, 1.26-3.41) than daily commuters in the adjusted model. CONCLUSION: Telecommuting was significantly associated with an increased risk of various health problems among South Korean workers and females were identified as a more vulnerable group. Although further research is required to ascertain the causal relationship, public health intervention should be considered to prevent the negative effects of telecommuting.

Use of work-related communication technology outside regular working hours and work-family conflict (work interference with family and family interference with work): results from the 6th Korean working conditions survey.

Background: Recently, use of work-related communication technology-smartphones, tablets, and laptops-is increasing rapidly by development of technology with the coronavirus disease 2019 pandemic. Some studies have suggested that work-related communication technology has a significant link with work-family conflict (WFC) but these studies included only limited number of participants and lacked essential covariates. Therefore, this study analyzes this association using large representative data sample and selected waged workers who were married-couples with children. Methods: This study was conducted based on data from the 6th Korean Working Conditions Surveys (KWCS). A total of 17,426 waged workers having a marriage partner and one or more children were selected. Logistic regression analysis was performed to determine whether WFC was associated with communication technology use. The odds ratios (ORs) for WFC were stratified by sex and working hours. Results: In fully adjusted model, WFC was higher those who used communication technology outside regular working hours compared with those who did not use it (OR: 1.66; 95% confidence interval [CI]: 1.39-1.97). When stratified by sex and working hours, the effect was greater in women than in men (OR: 1.79; 95% CI: 1.42-2.26 vs. OR: 1.52; 95% CI: 1.17-1.97) and women who worked over 52 hours per week had the highest OR (3.40; 95% CI: 1.25-9.26). Conclusions: This study revealed that the work-related communication technology use outside regular working hours was associated with WFC. The association were greater among those having longer working hours and female workers. These results suggest that appropriate policy should be implemented to reduce working hours and right to disconnect after work, particularly in female workers.