High rate of tibial post-fracture in highly cross-linked polyethylene compared to conventional polyethylene in posterior-stabilized total knee arthroplasty at a minimum 12-year follow-up.

PURPOSE: The purpose of this study was to assess tibial post-fracture between highly cross-linked polyethylene (HXPE) and conventional polyethylene inserts in consecutive posterior-stabilized (PS) total knee arthroplasty (TKA) over a minimum 12-year follow-up period. METHODS: Between January 2007 and June 2008, a consecutive series of 2446 primary TKAs was performed in 1478 patients at a single institution. The final cohort was classified into two groups (1559 in the HXPE group and 887 in the conventional group) based on the insert material used during the procedure. RESULTS: The mean follow-up period was 13.1 years in the HXPE group and 13.4 years in the conventional group. All 16 cases of tibial post-fracture occurred in the HXPE group. This complication rate was 1.03%. The mean elapsed time from primary TKA to the diagnosis of post-fracture was 3.9 years (range 0.5-10.0 years). Ten cases required replacement with a thicker polyethylene insert, and six cases underwent tibial revision surgery. There were no cases of tibial post-fracture in the conventional group. CONCLUSION: Tibial post-fracture is not a rare complication in PS TKA with HXPE. Therefore, the possibility of a tibial post-fracture should be considered if newly developed pain, acute subluxation, effusion, patellar clunking, or instability occurs in patients treated with PS Scorpio knee system TKA using an HXPE insert. LEVEL OF EVIDENCE: IV.

Prevalence of frailty and associated factors in Korean older women: The KLoSA study.

The purpose of this study was to identify the prevalence of frailty in older women and its associated factors using data from the Korean Longitudinal Study of Aging (KLoSA). The level of frailty was moderate/severe in 20.2% of the women. Age, socioeconomic status, and depressive symptoms were significantly associated with all levels of frailty. Sensory function and grip strength were associated with both mild and moderate/severe frailty. The only factors associated with moderate/severe frailty were marriage status and regular exercise. Understanding the risk factors of frailty may help health care providers to deliver tailored interventions to prevent this condition and its adverse outcomes.

Suicide Attempts and Associated Factors in Male and Female Korean Adolescents A Population-Based Cross-Sectional Survey.

Using data from the Korea Youth Risk Behavior Web-based Survey, this study seeks to investigate associations of suicide attempts with family, individual, and behavioral factors on the basis of gender. Among male adolescents, those who did not live with their parents, who had poor subjective academic achievement, depression, experiences of smoking and sexual coitus, drug abuse, suicidal ideation and plans were more likely to attempt suicide. Among the female adolescents, those who did not live with their parents, had depression, low self-rated health, experiences of drug abuse and sexual coitus, and expressed unhappiness, suicidal ideation and suicide plans were more likely to attempt suicide. Thus, the development of a suicide prevention program for Korean adolescents requires different approaches for males and females.

The relationship between social frailty and cognitive impairment among older adults: the role of various types of internet use.

Introduction: This study aimed to explore the role of internet use in the relationship between social frailty and cognitive function among Korean older adults. Methods: A nationally representative survey of community-dwelling older adults in Korea was used in the analysis (N = 8,639). Results: All types of internet use were significantly associated with cognitive impairment and played a significant role in the relationship between social frailty and cognitive impairment. The advantage of internet use for information searching (OR 0.40, 95% CI 0.35-0.46) was the greatest for cognitive function, followed by internet use for instrumental use (OR 0.59, 95% CI 0.53-0.66). Internet use for entertainment exhibited the greatest influence in the relationship between social frailty and cognitive impairment, with interpersonal communication ranking second in significance. Internet use regulates the relationship between social frailty and cognitive impairment in older adults. The influences of internet use vary depending on the type of online activity and the levels of social frailty. Discussion: This highlights the importance of considering various forms of internet use when developing non-pharmacological interventions to mitigate the impact of social frailty on cognitive decline.

Exploring the Role of Social Factors in Cognitive Frailty among South Korean Older Adults.

Cognitive frailty, which is characterized by the co-occurrence of physical frailty and cognitive impairment, poses significant risks to the well-being and independence of elderly individuals. Previous research has established that demographic, health-related, and social factors contribute to both physical frailty and cognitive decline. However, the role of social factors in influencing cognitive frailty remains unclear. This study aims to identify the relationship between social factors and cognitive frailty among Korean older adults living in the community. We performed secondary analyses of data from the 2020 Survey on Older Adults. After entering demographic factors and health-related factors into the logistic model as covariates, this study explored the association between cognitive frailty and social factors, including living arrangements, social support, the frequency of engagement in social activities per week, and satisfaction with friends and community. Among participants, approximately 2.9% had cognitive frailty, 3.2% had only physical frailty, and 21.9% had only cognitive decline. Lower levels of satisfaction with friends and the community and infrequent participation in social activities were strongly correlated with cognitive frailty. These findings emphasize the necessity of public health programs that encourage older individuals' social involvement. A supportive social environment can be fostered through initiatives that promote community events, group activities, and volunteerism. Public health policies should prioritize the development and maintenance of social activity centers that offer various programs to prevent progression to cognitive frailty in older adults.

Purposes of Internet Use and Its Impacts on Physical and Psychological Health of Korean Older Adults.

Older adults engage in online activities for various purposes. An increasing number of studies are establishing connections between the purposes of internet use and their impacts on health outcomes. This study aimed to examine how the purposes of internet use affect self-rated health and depressive symptoms among Korean older adults. A nationally representative survey of community-dwelling older adults in Korea was used in the analysis (n = 5094). Instrumental internet use (using the internet to access various forms of information, services, and other resources) in Korean older adults was as common as interpersonal communication use, and the purposes of internet use were mainly for information seeking for everyday needs and engaging in various activities for enjoyment. Internet use for interpersonal communication and instrumental purposes was significantly associated with depressive symptoms and self-rated health. Internet use for instrumental purposes had a greater impact on self-rated health (ß = -0.186) and depressive symptoms (ß = -0.160) compared with the impacts of interpersonal communication internet use on self-rated health (ß = -0.101) and depressive symptoms (ß = -0.047). The findings highlighted the necessity of designing interventions that take into account the different purposes of internet use for older adults in order to maximize its benefits, paying special emphasis for information seeking online.

Cross sectional association between cognitive frailty and disability among community-dwelling older adults: Focus on the role of social factors.

Background: This study aimed to investigate the prevalence of cognitive frailty and the influence of social factors on the association between different levels of cognitive frailty and disability. Methods: A nationally representative survey of non-institutionalized community-dwelling older adults in Korea was used. A total, 9,894 older adults were included in the analysis. We assessed the effects of social factors using social activities, social contacts, living arrangements, emotional support, and satisfaction with friends and neighbors. Results: The prevalence of cognitive frailty was 1.6%, which was consistent with other population-based studies. Hierarchical logistic analysis demonstrated that the association between different levels of cognitive frailty and disability was attenuated when social participation, social contact, and satisfaction with friends and community were included in the model, and the magnitude of these effects differed across the levels of cognitive frailty. Discussion: Considering the influence of social factors, interventions to enhance social relationships can help slow down the progression of cognitive frailty to disability.

Social Network Types and Depressive Symptoms among Older Korean Men and Women.

This study explores the social network types of older Korean men and women, and the relationship of those networks to depressive symptoms. A population of 4608 older adults who participated in the Living Profiles of Older People Survey (LPOPS) were included in the study. Seven criterion variables-marital status, living arrangements, frequency of contact with children, close friends, and close relatives, participation in social activities, and total network size-were included in a K-means cluster analysis. Multivariable logistic regression analysis of the impact of social network type on depressive symptoms was conducted. We identified two "diverse type" social networks (diverse-married and diverse-unmarried) in women, and one diverse type and one "social-activity-focused type" network in men. Family focused type and two "restricted type" social networks (restricted-couple-focused, and restricted-unmarried) were identified in both men and women. The restricted-unmarried and restricted-couple-focused networks were associated with more depressive symptoms in both men and women. However, the family focused type was associated with more depressive symptoms only in women. The results indicated that social network types, and their impact on depressive symptoms, differ by gender. There is a need for further research on gender differences in the social network types of older adults across diverse cultures.

Long-term survivorship of total knee arthroplasty with a single-radius, high-flexion posterior stabilized prosthesis.

BACKGROUND: The purpose of this study was to determine functional outcomes, implant survival rate, and complications of a single-radius, high-flexion posterior stabilized (PS) total knee prosthesis at a minimum follow up of 10 years for a consecutive series. METHODS: This retrospective observational study included 395 consecutive patients who underwent 585 single-radius, PS total knee arthroplasties (TKAs) between January 2009 and December 2009. Their functional outcomes, implant survival rates, radiological findings, and complications were evaluated. RESULTS: At a mean follow up of 11.2 years (range, 10.6-11.8 years), 395 (80.8%) patients were available for review. At final follow up, preoperative Knee Society knee scores were improved from 37.3 to 80.1 (P < 0.05) and function scores were improved from 35.7 to 80.5 points (P < 0.05). Sixteen knees (2.7%) in 15 patients required revision surgery due to 11 septic loosening (1.9%) and five aseptic loosening events (0.8%). Cumulative survival for the prosthesis was 97.3% for any cause at 10 years. A total of 34 radiolucent lines (5.8%) were detected an average of 2.4 years following surgery and radiological assessment did not reveal any evidence of component migration at final follow up. CONCLUSIONS: Single-radius, high-flexion PS TKA showed good long-term survival rates and clinical outcomes. Further study is required to determine whether limited radiolucency findings at the tibial component-tibial plateau could progress to or result in the loosening of components.

Gender Differences in the Impact of Intergenerational Support on Depressive Symptoms among Older Adults in Korea.

Background: This study examined the relationship between intergenerational support patterns and depressive symptoms among older men and women in Korea. Methods: A nationally representative survey of non-institutionalized, community-dwelling older adults in Korea was used. A total of 7531 older adults (3592 men and 3939 women) was included in the analysis. Results: We observed gender differences in the impact of financial support exchanges on depressive symptoms. A lack of mutual financial support significantly increased the risk of depressive symptoms by 3.83 times (95% CI 2.34-6.24) in men and 1.73 times (95% CI 1.06-2.83) in women. Men who received financial support were more likely to experience depressive symptoms (OR (Odds Ratio), 1.81, 95% CI 1.36-2.42), whereas women who provided financial support were more likely to experience depressive symptoms (OR 2.82, 95% CI 1.21-6.56). The lack of an exchange of emotional support was significantly associated with depressive symptoms in both men (OR 1.49, 95% CI 1.17-1.90) and women (OR 1.87, 95% CI 1.50-2.34). Conclusions: We discuss the evidence of gender differences in intergenerational support exchange patterns and their impact on depressive symptoms within the context of Korean cultures and suggest that future research should be conducted on gender differences in the impact of intergenerational support on mental health across diverse societies.

Social Networking Site Usage and Its Impact on Depressive Symptoms among Older Men and Women in South Korea.

Background: We examined the rate of social networking site (SNS) usage and the relationship between SNS usage and depressive symptoms among older men and women in South Korea. Methods: The data were obtained from the Living Profiles of Older People Survey (LPOPS), which comprises a nationally representative sample of non-institutionalized Korean older adults living in the community. A total of 10,073 older persons (4286 men and 5787 women) were included in the analysis. Results: A total of 26.0% of the total study population reported to use social network sites. Of the men and women, 32.6 and 21.1%, respectively, used SNS. A higher educational level and higher equivalent household income, lower number of chronic illnesses, no limitation in daily activities, living with others, and having good relationships with friends and neighbors were associated with higher SNS usage among older men and women. SNS usage was significantly associated with reduced depression scores in older men, but not in women. Conclusions: The difference in SNS usage between older men and women might be partially explained by differential exposure to digital technologies and disadvantages in education and economic opportunities. Education programs for digitalization and opportunities to engage with technology need to be provided.

Gender Differences in the Prevalence and Correlates of Elder Abuse in a Community-Dwelling Older Population in Korea.

BACKGROUND: We examined gender differences in the prevalence estimates and correlates of elder abuse in a community-dwelling older population in Korea. METHODS: We analyzed responses from the Living Profiles of Older People Survey (LPOPS), which comprises a nationally representative sample of non-institutionalized Korean older adults living in the community. A total of 10,184 older persons (4179 men and 6005 women) were included in the analysis. RESULTS: The overall rate of elder abuse was 9.9%, and emotional elder abuse was the most frequent type. Of the men and women subjects, 8.8 and 10.6%, respectively, had experienced elder abuse. We observed significant gender differences in the correlates of elder abuse. Educational attainment was significantly associated with elder abuse in men but not in women. Poor self-rated health was significantly associated with elder abuse in women but not in men. Household income and relationship with children were significantly associated with elder abuse in both men and women. CONCLUSION: Our results suggest that the factors that make elderly persons vulnerable to elder abuse may differ by gender. A better understanding of the risk factors for elder abuse across genders will facilitate the development of elder abuse prevention strategies, practices, and policies.

Gender differences in exposure and vulnerability to psychosocial and behavioral factors of suicide attempt among Korean adolescents.

INTRODUCTION: This study examined gender differences in suicide attempts and their association with exposure and vulnerability to psychosocial, behavioral, and structural factors among Korean adolescents. METHODS: Data of 74 854 adolescents, taken from the 2010 Korea Youth Risk Behavior Survey, were used. Logistic regression analysis was used to assess the contribution of differential exposure to psychosocial, behavioral, and structural factors for gender differences of suicidal attempt. RESULTS: Gender differences were observed in the degree of exposure to the various factors. Females were more likely to report psychosocial problems, whereas males were more likely to report experience of smoking and drinking alcohol and to engage in vigorous physical activity. Stress and unhappiness were significantly associated with suicide attempts in both males and females, and gender differences in these variables were nonsignificant. Depressive symptoms were associated with a higher risk of suicide attempts, and this relationship was significantly stronger for males. The effects of cigarette smoking and risky drinking were significantly stronger in females. DISCUSSION: Greater exposure to perceived stress, feelings of unhappiness, depression, and higher vulnerability of smoking and heavy drinking accounted for higher suicide attempts of female adolescents. Higher exposure to health-related behaviors and greater vulnerability to depressive symptoms in male were also noted. In conclusion, differences in exposure and vulnerability to psychosocial and behavioral factors may partly explain gender differences in suicide attempts among Korean adolescents.

Prospective Study on the Impact of Fear of Falling on Functional Decline among Community Dwelling Elderly Women.

Fear of falling (FOF) is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA). Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the "consistently having FOF" group, whereas they were lowest in the "consistently no FOF" group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF.

Impact of Living Alone on Depressive Symptoms in Older Korean Widows.

We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data from widows, 65 years of age and older, who participated in the Living Profiles of Older People Survey (LPOPS). A logistic regression analysis was used to evaluate the contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. Working status and equivalent household income were significantly associated with depressive symptoms in both those living with others and those living alone. Adjustment for health status and social ties did not change the impact of living alone on the prevalence of depressive symptoms. However, adjustment for equivalent household income eliminated the negative association between living alone and depressive symptoms. Our findings indicate that economic resources are more important than health and social ties for alleviating the negative impact of living alone on the development of depressive symptoms in older widows.

Characteristics Associated With Fear of Falling and Activity Restriction in South Korean Older Adults.

OBJECTIVES: The purpose of this study was to identify the characteristics associated with fear-induced activity restriction and determine those that distinguish older adults with fear-induced activity restriction from those with fear of falling alone. METHOD: Data taken from the survey of the Korean Longitudinal Study of Aging in 2010 were analyzed. Multiple logistic regression analysis was used to assess factors associated with fear of falling and fear-induced activity restriction. RESULTS: A total of 22.5% of the participants reported no fear of falling, 48.6% reported fear of falling alone, and 28.9% reported fear-induced activity restriction. Characteristics independently associated with fear-induced activity restriction were low socioeconomic status, cognitive impairment, difficulty with activities of daily living, and a history of injurious falls. DISCUSSION: The differences between older adults with fear-induced activity restriction and those with fear of falling alone may guide refinement of intervention and preventive programs.

[Homebound status and related factors according to age in female elders in the community].

PURPOSE: The purpose of this study was to investigate homebound status and significant related factors for community-dwelling female elders according to age. METHODS: The participants were female elders over 65 years of age registered in public health centers. Data were collected by interviewing the elders, who voluntarily completed the entire survey. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 18.0. RESULTS: There were statistically significant differences in homeboundness and related factors between the young-old (65 to 74 years of age) and the old-old (75 years of age or older). The level of homeboundness of the old-old was higher than that of the young-old. Multiple logistic regression showed, timed "up and go", depression, and fear of falling as significantly associated with homebound status of the young-old, while hand grip strength (right), timed "up and go", static balance ability, severity of urinary incontinence, and fear of falling as significant for the old-old. CONCLUSION: The findings of this study indicate that homebound status and related factors for elders are different according to age, and therefore, interventions to prevent and help homebound elders get over being homebound should be developed according to age.