The role of nutritional status in the relationship between diabetes and health-related quality of life.

BACKGROUND/OBJECTIVES: The association between nutritional status and health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) is not fully understood. This study was conducted to understand the role of nutritional status on HRQoL among people with and without T2DM. SUBJECTS/METHODS: Structured survey and direct measurement of anthropometric data were conducted among people with and without T2DM. Nutritional status was measured with Mini Nutritional Assessment tool and HRQoL was measured with a 36-item Short Form Healthy Survey. Data collection was conducted in Chuncheon, South Korea with 756 participants who are older than 40 yrs of age. RESULTS: This study found that overall HRQoL were significantly lower in people with T2DM than people without T2DM after controlling for key covariates. When stratified by nutritional status, a greater degree of negative impact of T2DM on overall physical HRQoL was observed among well-nourished or at risk of malnutrition, whereas significant and more evident negative impact of diabetes on overall psychological HRQoL was observed only among malnourished. CONCLUSIONS: The study results suggest the role of nutritional status among people with T2DM on overall, especially psychological aspects of HRQoL. Future longitudinal or intervention studies are warranted to test the impact of nutritional status on HRQoL among people with T2DM.

Quality of life of older adults with cancer in Korea.

This study examines the quality of life (QoL) of older adults with cancer (N = 176), by comparing them with age- and gender-matched groups without cancer (N = 176), and investigates factors associated with their QoL. The results of Medical Outcome Study Short Form-36 (MOS SF-36) showed that the study group had significantly lower scores than the noncancer group on all eight scales and on the Physical Component Summary and the Mental Component Summary. Comparison with gender and age groups revealed some differences. Optimism and social support were positively related to QoL while comorbidity, cancer-related concerns, and financial worries were inversely related.

The Effect of Widowhood on Parent-Child Relationships in Korea: Do Parents' Filial Expectations and Geographic Proximity to Children Matter?

Although previous research based on data from the U.S. suggests that parents' widowhood is associated with increased emotional support from children, little is known about the impact of late-life widowhood on intergenerational relationships in other cultures. Using data of Korean older adults, this paper examined: (1) the effect of widowhood on both positive and negative aspects of parent-child relationships and (2) whether these effects are moderated by older adults' expectations about children's filial responsibilities and the geographic proximity to their children. Analyses are based on data from the Hallym Aging Study, a stratified multi-stage probability sample of older adults living in the cities of Seoul and Chuncheon in Korea. Compared to married older adults, widowed persons in this sample reported higher levels of ambivalence, lower levels of positive interactions, and higher levels of negative interactions with their children. Parents' notion about filial responsibilities did not have a significant moderating effect, whereas geographic proximity to children was a significant moderator. Findings suggest that widowhood is associated with greater strain in intergenerational relationships in Korea. Helping widowed older adults forge constructive relationships with their children may enhance both bereaved older adults' and their children's well-being in this cultural milieu.

Factors affecting quality of life of older adults with cancer in Korea.

AIM: The main objective of the present study was to examine the quality of life of older adults with cancer and investigate factors associated with it. Some practical problems experienced by older adults with cancer are introduced, such as changes in work situation, availability of caregivers and financial difficulties relative to medical expenditures. METHODS: A total of 339 patients aged 65 years or older who were treated for five major cancer diseases--colorectal, stomach, lung, liver or kidney cancer--participated in the present study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was used to measure the quality of life. Performance status (physical functioning) was assigned according to the Eastern Cooperative Oncology Group classification. The Life Orientation Test-Revised was used to assess future expectations. The multiple linear regression analysis was used to identify predictors of the quality of life of older persons with cancer. RESULTS: The results showed that physical functioning and optimism were significant predictors of all four functions (physical, role, emotional and social function) and global quality of life of older adults with cancer. Nearly 60% experienced changes in work situation and had financial burden on medical costs. CONCLUSIONS: The findings suggest that efforts to assess physical functioning with more attention and enhance optimism should be emphasized in interventions for older adults with cancer.

Korea: balancing economic growth and social protection for older adults.

Population aging in Korea is projected to be the most rapid among Organisation for Economic Co-operation and Development (OECD) countries between 2000 and 2050. However, social spending in Korea remains low, reflecting Korea's relatively young population, limited health and long-term care insurance coverage, and immaturity of its pension system. As these factors evolve in coming years, social spending in Korea is likely to rise toward the OECD average. Sustaining economic growth requires policies to mitigate the impact of rapid population aging by providing social protection for the elderly population. Korea confronts difficult challenges in balancing economic growth and social protection for the elderly population, whereas also ensuring efficiency in social spending.

CpG DNA-mediated induction of acute liver injury in D-galactosamine-sensitized mice: the mitochondrial apoptotic pathway-dependent death of hepatocytes.

Unmethylated CpG motifs present in bacterial DNA (CpG DNA) induce innate inflammatory responses, including rapid induction of proinflammatory cytokines. Although innate inflammatory responses induced by CpG DNA and other pathogen-associated molecular patterns are essential for the eradication of infectious microorganisms, excessive activation of innate immunity is detrimental to the host. In this study, we demonstrate that CpG DNA, but not control non-CpG DNA, induces a fulminant liver failure with subsequent shock-mediated death by promoting massive apoptotic death of hepatocytes in D-galactosamine (D-GalN)-sensitized mice. Inhibition of mitochondrial membrane permeability transition pore opening or caspase 9 activity in vivo protects D-GalN-sensitized mice from the CpG DNA-mediated liver injury and death. CpG DNA enhanced production of proinflammatory cytokines in D-GalN-sensitized mice via a TLR9/MyD88-dependent pathway. In addition, CpG DNA failed to induce massive hepatocyte apoptosis and subsequent fulminant liver failure and death in D-GalN-sensitized mice that lack TLR9, MyD88, tumor necrosis factor (TNF)-alpha, or TNF receptor I but not interleukin-6 or -12p40. Taken together, our results provide direct evidence that CpG DNA induces a severe acute liver injury and shock-mediated death through the mitochondrial apoptotic pathway-dependent death of hepatocytes caused by an enhanced production of TNF-alpha through a TLR9/MyD88 signaling pathway in D-GalN-sensitized mice.

Factors associated with family caregivers' burden and depression in Korea.

This study determines the relative effects of functional impairment, cognitive impairment, and duration of care of the elderly on caregivers' depression, and identifies the factors that influence this relationship. The variables were entered individually, based on a logical order in the path modeling. For mediators, the order of three types of social support was assumed to be financial support, instrumental support, and emotional support. The order of five dimensions of caregiver burden was assumed to be impact on finances, feelings of abandonment, impact on schedule, impact on health, and sense of entrapment. Findings indicate that functional impairment had both direct and indirect effects on caregiver depression, and direct effects on impact on schedule, impact on health, and sense of entrapment. The effect of cognitive impairment on caregiver depression was primarily indirect but had direct impact on sense of entrapment. Duration of care had no direct effect on caregiver depression and burden, but did have indirect effects on impact on finances, feelings of abandonment, and impact on health through emotional support. Caregivers of elders with functional impairment were more likely to give care for longer periods, and those who give care for longer periods were likely to receive less emotional support and experience more burden in the dimensions of impact on finances, feelings of abandonment, and impact on health. Caregivers who experience greater impact on finances and impact on health ultimately were at higher risk of depression. The results have important implications for intervention models aimed to increase emotional support for the caregiver.