Changes in depression trends during and after the COVID-19 pandemic among older adults in Korea.

This study aimed to complement the previous studies conducted within a short period of time by examining the long-term trends in depression levels of older adults through a longitudinal study that includes the period following the onset of COVID-19. For analysis, this study used the data from the 12th (2017) through 16th (2021) Korea Welfare Panel Study, and 2,716 data of older adults 65 years and older were included. Variables included gender, age, equalized annual income (USD $), education background, residential area, living alone and disability status. As a result, two types of changes in depression were identified: the 'rapidly rising' type and the 'steadily increasing'. We found that the lower the equalized annual income, women, the lower the education, living in urban and living alone showed a higher likelihood of belonging to the 'rapidly rising' type. The result suggests that those at risk of depression are at much higher risk during and after the COVID-19 pandemic. It is also necessary to provide timely and effective guidelines to prevent depression in older adults when implementing policies in response to an outbreak of infectious diseases, such as COVID-19.

A study on longitudinal relationship between ultrafine dust and the prevalence of depression.

BACKGROUND: Recently, the fine dust problem caused by rapid industrialization and science and technological development has emerged as a severe social issue worldwide. This also increases the interest in its effect on human life. In particular, there is a growing concern about the harm of fine dust in Korea. METHODS: This study is based on the PM 2.5 data from 2017 to 2021 provided by Air Korea to estimate changes in ultrafine dust. In addition, the data from the Community Health Survey provided by the Korea Centers for Disease Control and Prevention (KCDC) from 2017 to 2021 were used to examine the effect between the change in ultra-fine dust and the prevalence of depression. A total of 229 local governments were included in the analysis. The Latent Growth Modeling was carried out to estimate the change in ultra-fine dust and the prevalence of depressions and verify the relationship between ultra-fine dust and the prevalence of depression. RESULTS: The analysis result revealed that the ultra-fine dust concentration continued to decrease from 2017 to 2021. However, the depression prevalence increased from an average of 2.60% in 2017 to an average of 3.12% in 2021, suggesting the need for adequate and sufficient welfare policies for depression treatment. As a result of estimating the initial value and change rate of ultra-fine dust and depression prevalence, the higher the initial value of ultra-fine dust, the greater the decrease in ultra-fine dust. In terms of depression, the lower the initial value of the prevalence of depression, the larger the increase in depression prevalence. CONCLUSIONS: This study is significant in that it revealed the strong association of the longitudinal relationship between ultra-fine dust and depression, one of the biggest issues in Korea, by utilizing large-scale longitudinal data.

A Study on the Longitudinal Relationship between Changes in Depression and Cognitive Function among Older Adults Living Alone.

BACKGROUND: As South Korea faces unprecedented population aging, this longitudinal study examined the relationship between depression and cognitive function changes in older individuals living alone. METHODS: The study used data from the Korean Longitudinal Study of Aging (KLoSA). A total of 1354 participants with data available over a period of at least three years, from 2016 (wave 1) to 2020 (wave 8), were included, and latent growth modeling (LGM) was used for analysis. RESULTS: Depression levels increased gradually among older individuals living alone and cognitive function declined over time among older adults living alone. Moreover, higher initial depression levels were associated with lower initial cognitive function levels and a more rapid cognitive decline over time. Therefore, it is imperative that depression be addressed as a potential cause of cognitive impairment and dementia. Furthermore, rapid increases in depression corresponded to rapid declines in cognitive function, indicating the need for continuous monitoring and intervention in cases of escalating depression, as it may negatively affect cognitive abilities. CONCLUSIONS: These findings highlight the complex interplay between depression and cognitive function among older individuals living alone. Policy support to encourage participation in these programs is crucial to enhance the well-being of this vulnerable population.

Predictors of Variation in the Cognitive Function Trajectories among Older Adults Living Alone: A Growth Mixture Modeling Approach.

BACKGROUND: Considering the global aging population, this study investigates changes in cognitive function and predictive factors among older adults living alone. METHODS: Using data collected from the Korean Longitudinal Study of Aging (KLoSA), the study examines 1217 participants to identify distinct cognitive change patterns and the variables affecting them. RESULTS: Two primary cognitive function change types emerged: "High-Level Declining Type" and "Low-Level Stable Type." Although the former initially displayed normal cognitive function, it gradually declined over a period of 14 years until it reached mild cognitive impairment (MCI) levels by the year 2020. While the latter group had lower cognitive function from the beginning and remained stable throughout the study. Older age, female gender, rural residence, lower education, lower income, unemployment, and higher levels of depression were linked to a higher likelihood of belonging to the "Low-Level Stable Type". CONCLUSIONS: The findings of these studies emphasize the need for proactive interventions and regular cognitive assessments for older individuals living alone, as cognitive impairment can develop even in individuals whose cognitive abilities are initially good. Also, tailored interventions should target specific demographic and socioeconomic groups to mitigate cognitive decline effectively.

Gender Differences in Suicide Rates of Municipalities in South Korea.

Background: South Korea showed the highest suicide rate among the countries in the Organization for Economic Cooperation and Development. Aims: This study aimed to discern the profiles of municipalities according to their suicide rates across the life cycle and gender, and then to identify the unique characteristics of each latent group. Method: This study applied a latent profile modeling to categorize the regions by life cycle suicide rates of their residents. The latent profile analysis (LPA) yielded four latent groups for males and three groups for females. This study explored the unique characteristics of 250 municipalities by latent groups with these groups. Results: The results suggested significant gender differences in the characteristics of localities. For the high adolescent suicide rates groups, there was a higher proportion of urban areas among males while there was a higher proportion of rural regions among females. Limitations: This study analyzed secondary data of municipalities, so the characteristics of each profile of suicide rate could only be identified within this existing data. Conclusions: This paper is one of the first studies to apply the LPA to different latent profiles by life cycle suicide rates.

The relationship between changes in the korean fertility rate and policies to encourage fertility.

BACKGROUND: Korean government has established various policies to counter the low fertility rate since the mid-2000s, but it still has the lowest fertility rate among OECD member countries. This study investigated the relationship between changes in the Korean fertility rate and policies to encourage fertility. METHODS: This study utilized data of the total fertility rate of 250 local governments between 2014 and 2018, and a casebook of local government birth promotion policies. The dependent variable was fertility rate, and the independent variable was fertility promotion policy. Using SPSS 25.0 and M-plus 8.0 programs, descriptive statistical analysis and latent growth modeling were conducted. An unconditional quadratic function change model was selected as a final model of this study. RESULTS: The average of the initial fertility rate and the linear rate of change in the Korean fertility rate, and the rate of change of the quadratic function were all statistically significant, meaning that the fertility rate of decline increases over time. Also, the linear rate of change and the quadratic function change rate were significant, showing significant differences in the initial level and rate of change of the fertility rate between local governments. Among fertility policies, only the in-kind policy had a significant effect on the initial value of the fertility rate, meaning that the higher the number of in-kind policies, the higher the fertility rate. CONCLUSION: This study is crucial as it examined the changes in the fertility rate of Korean local governments as well as the policy factors affecting the fertility rate at a quantitative level.

A Longitudinal Relationship Between Mother's Smartphone Addiction to Child's Smartphone Addiction.

Children are more likely to become addicted as they become accustomed to using smartphones, and as they observe and imitate their parents using smartphones. This study aims to confirm longitudinally the effect of mother's smartphone addiction on children's smartphone addiction. Latent growth modeling was used to analyze longitudinal relationships between 3615 pairs of children and their mothers from the Korean Children and Youth Panel Survey (KCYPS) (2018-2020). As a result, both the mothers and children's smartphone addiction significantly increased over time. The initial value of the mother's smartphone addiction was found to have a significant effect on the child's initial value and the change rate. Moreover, children's smartphone addiction change rate was significantly affected by the change rate of the mother's smartphone addiction. To intervene in children's smartphone addiction, a family-level approach, as well as parental addiction, must also be addressed, and a preventive approach should focus on those with a low risk of addiction.

A Study on Types of Medication Adherence in Hypertension among Older Patients and Influencing Factors.

BACKGROUND: Hypertension has the characteristic that the risk of complications can be reduced through appropriate medication in daily life. Hence, it is important to consider practical measures to increase medication adherence, particularly among older patients. METHODS: This study used the Korea Health Panel 2020 data (Version 2.0.1), jointly conducted by Korea Institute for Health and Social Affairs and National Health Insurance. A total of 2300 patients with high blood pressure over 65 years of age were selected. In order to identify types of medication adherence in older hypertensive patients, and examine factors that influence the types, the Latent Profile Analysis (LPA) and logistic regression were performed. RESULTS: The types of adherence groups were classified into two groups: an 'adherence group' (87.1%) and a 'non-adherence group' (12.9%). Furthermore, age, living alone, and depressive symptoms were identified as determinants of medication adherence type among older hypertensive patients. CONCLUSION: The significant impact of sociodemographic status (age, living alone, and depressive symptoms) on medication adherence among older hypertensive patients indicates the need to establish more specific empirical interventions based on each type's characteristics. It is expected that this study will provide an in-depth understanding of factors associated with medication adherence among older patients with hypertension, which can support interventions tailored to the specific needs of those who are non-adherent.

Changes in the Suicide Rate of Older Adults According to Gender, Age, and Region in South Korea from 2010 to 2017.

BACKGROUND: South Korea's suicide rates are the highest among Organization for Economic Co-operation and Development (OECD) countries, making it one of the most important societal issues in South Korea. METHODS: the statistics on causes of death and resident registration central population (RRCP) provided by the National Statistical Office were used to calculate the suicide rate among older adults in Korea. We examined gender (male, female), age (young-old, old-old), and region (urban, rural) by conducting latent growth modeling to estimate changes in the overall older adult suicide rate and verify its relationship. RESULTS: over a period of 8 years, the older adult suicide rate was 104.232 on average in 2010 and it decreased by approximately 10.317 every year, and the rate of decrease gradually slowed down. The initial value of the older adult suicide rate was found to be higher among males, the old-old group, and those living in rural regions. In the quadratic function change rate, only males and the old-old group were statistically significant. CONCLUSION: in this study, the direction of and the rate of change in the older adult suicide rates and the relationship between gender, age, and region were examined. It is expected that this study will provide basic data to assist in establishing older adult suicide prevention policies, considering the gender, age, and region of the aging population.

Effects of Changes in Smoking Behavior of Older Adults' Oral Health.

While smoking is a crucial health risk, it adversely affects oral health, particularly becoming riskier for older adults who have smoked for a long time. This study identifies the patterns of smoking behavior changes in older adults aged 65 years and older and examines how the smoking behavior changes affect their oral health. Longitudinal data were derived from Korean Longitudinal Study of Aging (KLoSA) between 2006 and 2018, targeting the older adults 65 years and older in South Korea. The independent variable was the amount of smoking, and the dependent variable was oral health. For data analysis, SPSS 25.0 and M-plus 8.0 programs were utilized. As a result, the patterns of changes in smoking behavior of the older adults finally derived were 'non-smoking,' 'decreasing,' 'high-level maintenance,' and 'decreasing after increasing.' Furthermore, the relationship between the smoking behavior change pattern of the older adults and oral health was revealed. Specifically, as for the smoking behavior change pattern of the older adults, it was confirmed that the oral health was better in the 'non-smoking' pattern compared to the 'high-level maintenance' pattern. On the other hand, it was confirmed that the 'decreasing' pattern and the 'decreasing after rising' pattern did not significantly affect oral health. The findings imply that even if older adults smoked a lot in the past, if they quit smoking at some point, it can positively affect their oral health. Furthermore, it is suggested to allow public officials, medical professionals, and welfare experts to actively intervene for older adults to stop smoking for their oral health.

The Moderating Effect of Gender on the Relationship Between Self-neglect and Suicidal Ideation in Older Adults of Korea.

OBJECTIVES: Previous studies have reported that self-neglect, which may be a sign of elder abuse, can result in suicide among older adults. The signs of self-neglect and its impact on the risk of suicide may differ by gender. Thus, this study explored the association between self-neglect and suicide risk in older Korean adults and examined the potential moderating effect of gender on this relationship. METHODS: Data were collected from 356 Korean adults aged 65 or older through an online survey. Multiple regression analysis was used to test the research hypothesis. First, the associations between 4 sub-dimensions of self-neglect (i.e., daily life management issues, personal hygiene issues, financial management issues, and relational issues) and suicidal ideation were examined. Then, the moderating effect of gender on these relationships was investigated by including interaction terms. RESULTS: Self-neglect was significantly associated with suicidal ideation in older adults. Aspects of self-neglect related to daily life management and relational factors were key predictors of suicidal ideation. Gender significantly moderated the effect of the relational dimension of self-neglect on suicidal ideation. The relational dimension of self-neglect was more strongly associated with suicidal ideation in older women than in older men. CONCLUSIONS: The findings suggest the importance of screening older adults with signs of self-neglect for suicide risk. Special attention should be paid to older women who experience relational issues as a high-risk group for suicidal ideation. Public programs and support systems should be established to improve daily life management and promote social relationships among older adults.

A Study on the Relationship between Depression Change Types and Suicide Ideation before and after COVID-19.

BACKGROUND: The purpose of this study is to explore and categorize changes in depression, and investigate the relationship between suicidal ideations before and after the COVID-19 pandemic. METHODS: In this study, data from the Korea Welfare Panel Study (KoWePS) was used and included 8692 adults, 19 years of age or older, who could estimate the change in depression from 2017 (12th) to 2021 (16th) for final analysis. Depression change was classified into two types, 'low-level ascending' type (n = 7809, 80.9%), and 'increasing after reduction' type (n = 883, 10.2%). The Firth Method was used to examine the relationship between depression change types and suicidal ideation. RESULTS: The lower the equivalized annual income and the lower the educational level, and the likelihood of belonging to the 'increasing after reduction' type, compared to the 'low-level ascending' type, the greater the probability of having suicidal ideation. CONCLUSION: The significant impact of socioeconomic status (income and educational background) on suicidal ideation indicates the need to consider how epidemics affect inequality in society. This study is expected to provide a deeper understanding of depression, as well as to establish a foundation for long-term prevention of the rapid increase in suicide rates after COVID-19.

Mediating Effect of Cognitive Function on the Relationship Between Geriatric Oral Health and Quality of Life Among Korean Seniors.

OBJECTIVES: Previous studies have found that the oral health of seniors can affect their physical nutrition and quality of life (QoL). Additionally, poor oral health can lead to the development of dementia, which is associated with decreased cognitive function. This study aimed to examine the impact of geriatric oral health (GOH) on the QoL of Korean seniors and the mediating effects of cognitive function. METHODS: We used data from the seventh Korean Longitudinal Study of Aging conducted in 2018. In total, 4049 seniors were included in our study. We analyzed the impact of GOH on QoL according to 5 mediating domains of cognitive function and control variables. To examine each path of mediating effects, bootstrapping with 5000 iterations was performed with 95% confidence intervals. RESULTS: Our findings revealed that good GOH had a positive effect on the QoL of seniors. Also, better GOH corresponded to a higher degree of cognitive function within all 5 domains: orientation, memory registration, attention/calculation, memory recall, and language and visuospatial ability. In addition, 3 domains of the 5 domains (attention/calculation, memory recall, and language and visuospatial ability) had significant mediating effects on the relationship between GOH and QoL. CONCLUSIONS: This study suggests that adequate management of GOH is crucial for promoting a better QoL and a high degree of cognitive function among seniors. To prevent cognitive impairment, such as dementia, future studies should take a more targeted approach by examining data according to each cognitive domain and various socio-demographic factors.

Changes in Types of Drinking Behavior in Korean Adults: Differences in Demographics, Depression, and Suicidal Thoughts.

Background: Longitudinal studies of drinking behavior have reported inconsistent changes in drinking behavior as people age. Thus, this study aims to characterize the changes in drinking behavior among Korean adults and to reveal differences in their demographics, depression, and suicidal thoughts. Methods: This study used the Korea Welfare Panel Study data over nine years (2009 to 2017), analyzing a total of 7506 participants. Growth mixture modeling was applied to classify patterns of change in drinking in these participants. The χ2 test and analysis of variance were used to analyze the differences in demographics, depression, and suicidal thoughts according to patterns of change in drinking. Results: Changes in drinking among Korean adults were categorized into four types: "high-risk retention", "medium-risk to high-risk", "high-risk to low-risk", and "low-risk retention". Gender, age, education, marital status, living arrangement, living area, and depression differed among these groups. Conclusion: We identified four types of changes in adult drinking behavior in South Korea, which varied in their demographics and depression levels. These results suggest that tailoring interventions to the type of behavioral changes might be more useful than batch interventions.

The Effects of Children's Smartphone Addiction on Sleep Duration: The Moderating Effects of Gender and Age.

BACKGROUND: Smartphones are an important part of children's and adolescents' lives, and they often spend a lot of time using them. This study aims to precisely discover the effects of smartphone addiction on sleep duration as moderated by age and gender. MATERIALS AND METHODS: The data utilized in this study are from the 'Korean Children and Youth Panel Survey 2018' by the National Youth Policy Institute; a total of 4940 youths (2399 in grade 4 and 2541 in grade 7) from the survey were analyzed by Stata 15.0 S. The dependent variable is sleep duration, and the independent variables are the sub-factors of smartphone addiction: disturbance of adaptive functions, virtual life orientation, withdrawal, and tolerance. An independent t-test was conducted to confirm the differences in the main variables according to gender and age. Multiple regression analysis was conducted to verify the moderating effects of gender and age in the relationship between children's smartphone addiction and sleep duration. RESULTS: First, the average sleep duration among grade 4 students was 9.17 h and grade 7 students was 7.96 h. Second, sleep duration was significantly higher for males than females, while there was no difference in smartphone addiction by gender. Third, smartphone addiction, particularly the sub-factor of tolerance significantly affected sleep duration. Fourth, age significantly affected sleep duration and gender had a moderating effect on sleep duration. CONCLUSIONS: Interventions to develop a healthy smartphone usage culture on family and societal levels would be beneficial for increasing awareness of smartphone addiction and its adverse effects on children and adolescents. Furthermore, targeted intervention would be more effective at modifying addictive behavior and sleep duration than trying to administer blanket interventions to youths as a whole.

The Effects of Korean Parents' Smartphone Addiction on Korean Children's Smartphone Addiction: Moderating Effects of Children's Gender and Age.

Background: Smartphone addiction among children and adolescents has a negative effect, as excessive use of smartphones can cause physical symptoms, such as fatigue, indigestion, and sleep problems, as well as psychopathological problems, such as depression, anxiety, and impulsiveness. Materials and Methods: This study was carried out using the Korean Children and Youth Panel Survey 2019 conducted by the National Youth Policy Institute. The total number of participants was 4656 youths (2290 in grade 5 and 2366 in grade 8), and the dependent and independent variables were smartphone addiction in children and parents, respectively. Multiple regression analysis was conducted by Stata 15.0 SE. Results: First, the level of parents' smartphone addiction affected that of children and adolescents. Second, the children's and adolescents' age affected the level of smartphone addiction, while their gender did not affect it. Third, the relationship between the levels of parents' and children's smartphone addiction was not moderated by the genders and ages of the children and adolescents. Conclusions: It was confirmed that as parents' smartphone addiction increased, that of children increased, and smartphone addiction was found to increase in the second grade of middle school (12 years old) rather than grade 5 of elementary school (10 years old). Parents' and children's smartphone addiction was not moderated by children's and adolescents' gender and age.

Regional Suicide Rate Change Patterns in Korea.

Background: Korea had the highest suicide rate among OECD countries for the 10 years leading up to 2016; however, the suicide rate in Korea has declined since 2010, after policy-driven interventions were implemented. Methods: Suicide rates from all of the 229 cities, counties, and districts in Korea were reliably estimated from the period 2010 to 2017, and data were examined by Stata 14.0 and M-plus to identify regional suicide rate change patterns by latent growth modeling. The dependent variable is the suicide rate, and independent variables as characteristics of the various districts are the region (cities, counties, and autonomous districts), proportion of elderly residents, financial independence rate, establishment of mental health and welfare centers, and number of social welfare facilities. Results: Three suicide rate change patterns were identified: 'average', 'precipitous drop', and 'high level'. Two of the three patterns exhibit features that are markedly different to the national data as a whole, and the three patterns appear across the 229 cities, counties, and districts of Korea. Some of the determinant factors have been postulated here. While a high proportion of elderly residents in a given area is a significant indicator that the suicide rate will increase, having a large elderly population in combination with an increased number of social welfare facilities centers appeared to show a discrete pattern of suicide rate reduction when compared with average national data. Conclusions: Policy-driven interventions should be planned and implemented by central and local governments in conjunction, by considering regional characteristics to decrease local suicide rates more effectively.