Comparison of lifestyle, cognitive function, mental health, and quality of life between hospitalized older adults with COVID-19 and non-COVID-19 in South Korea: a cross-sectional study.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has greatly impacted older adults, resulting in many deaths. The impact of lifestyle and mental health on vulnerable groups, such as older adults, can be large and long lasting. Therefore, this study aimed to investigate the effects of COVID-19 confirmation on cognition, lifestyle, mental health, and quality of life in adults aged 55 years. METHODS: The sample consisted of 111 people in the COVID group and 189 people in the non-COVID group aged over 55 years in South Korea. An online survey was conducted between January and May 2022. Participants responded to the following assessment tools: Yonsei Lifestyle Profile, Prospective and Retrospective Memory (PRMQ), Subjective Memory Complaints Questionnaire (SMCQ), Visual Analogue Scale, Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Fear of COVID-19 Scale (FCV-19 S), and the World Health Organization Quality of Life Scale abbreviated version (WHOQOL-BREF). Differences in lifestyle, cognition, depression, anxiety, and quality of life were compared between the two groups. RESULTS: There were significant differences in physical activity, diet, the total score of the PRMQ, PM (a sub-score of the PRMQ), PHQ-9, Korean version of the ISI (ISI-K), and WHOQOL-BREF scores between the COVID and non-COVID groups. However, there were no significant differences in activity participation, Self-Rating Anxiety Scale (SAS), or FCV-19 S between groups. CONCLUSIONS: The study confirms that COVID-19 negatively affects memory, physical activity, diet, quality of life, depression, and insomnia in the older adults. Therefore, this study implicated that prevention and intervention strategies required improving the memory, lifestyle, and mental health of older adults with COVID-19. TRIAL REGISTRATION: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Yonsei university in Korea (Registration number: 1041849-202112-SB-226-03, Date of registration: 01042022).

Salmonellosis outbreaks linked to eggs at 2 gimbap restaurants in the Republic of Korea.

Objectives: Salmonellosis outbreaks occurred at 2 restaurants 2 days apart, and an epidemiological investigation was conducted to determine whether the outbreaks were connected. Methods: Case studies were conducted for both outbreaks. Stool samples were collected from individuals, and food samples were collected from the restaurants. Pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing analyses were performed on outbreak-related Salmonella enterica serovar Enteritidis (Salmonella Enteritidis) isolates. Traceback investigations were also conducted for the ingredients from gimbap restaurants A and B. Results: In total, 106 people from gimbap restaurant A and 5 from gimbap restaurant B met the case definition. Salmonella Enteritidis was detected in samples from 2 food handlers, 22 patients, and 1 food (iceberg lettuce) at gimbap restaurant A and from 1 patient at gimbap restaurant B. According to PFGE, all isolates were identified as SEGX01.089. The molecular typing of all isolates showed the same pattern, and the genetic distance was close according to phylogenetic analysis. Eggs were the only food ingredient that was supplied to both gimbap restaurants. Conclusion: The outbreaks were caused by Salmonella Enteritidis, and the source of infections was suspected to be contaminated eggs. To prevent foodborne outbreaks of Salmonella, restaurants should heat eggs sufficiently, and egg farms need to establish management systems that prevent Salmonella infections.

Timosaponin A3 Induces Anti-Obesity and Anti-Diabetic Effects In Vitro and In Vivo.

Obesity is a serious global health challenge, closely associated with numerous chronic conditions including type 2 diabetes. Anemarrhena asphodeloides Bunge (AA) known as Jimo has been used to address conditions associated with pathogenic heat such as wasting-thirst in Korean Medicine. Timosaponin A3 (TA3), a natural compound extracted from AA, has demonstrated potential therapeutic effects in various disease models. However, its effects on diabetes and obesity remain largely unexplored. We investigated the anti-obesity and anti-diabetic properties of TA3 using in vitro and in vivo models. TA3 treatment in NCI-H716 cells stimulated the secretion of glucagon-like peptide 1 (GLP-1) through the activation of phosphorylation of protein kinase A catalytic subunit (PKAc) and 5'-AMP-activated protein kinase (AMPK). In 3T3-L1 adipocytes, TA3 effectively inhibited lipid accumulation by regulating adipogenesis and lipogenesis. In a high-fat diet (HFD)-induced mice model, TA3 administration significantly reduced body weight gain and food intake. Furthermore, TA3 improved glucose tolerance, lipid profiles, and mitigated hepatic steatosis in HFD-fed mice. Histological analysis revealed that TA3 reduced the size of white adipocytes and inhibited adipose tissue generation. Notably, TA3 downregulated the expression of lipogenic factor, including fatty-acid synthase (FAS) and sterol regulatory element-binding protein 1c (SREBP1c), emphasizing its potential as an anti-obesity agent. These findings revealed that TA3 may be efficiently used as a natural compound for tackling obesity, diabetes, and associated metabolic disorders, providing a novel approach for therapeutic intervention.

Application of a cognitive program with a comprehensive strategy feedback for Korean older adults.

This study assesses the effect of a cognitive program with a comprehensive strategy feedback on the cognitive function and memory self-efficacy of community-dwelling older adults and explores its applicability in Korea. The study employed a group pre-posttest design on 10 cognitively normal older participants. The four-week cognitive program involved daily completion of cognitive tasks at home using CoTras-Pro 2 and remotely provided individual non-face-to-face feedback. Additionally, biweekly face-to-face group feedback sessions were conducted with five participants. The Korean version of the Montreal Cognitive Assessment, the Korean-Color Word Stroop Test, and the Memory Self-Efficacy Questionnaire were used. Post-interviews were conducted to collect feedback. The program exerted a notable positive impact on cognitive function and memory self-efficacy. A study designed as a large-scale program conducted in collaboration with community-based public and private organizations holds the potential to be modeled for similar intervention programs involving a large number of participants.

Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging.

OBJECTIVES: Few longitudinal studies have explored age-related differences in the relationship between lifestyle factors and cognitive decline. This study investigated lifestyle factors at baseline that slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals. METHODS: We conducted an 11-year follow-up that included 6,189 older adults from the Korean Longitudinal Study of Aging, which is a cohort study of community-dwelling older Koreans. Lifestyle factors, including physical activity, social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over 11 years. Latent growth modeling and multi-group analysis were performed. RESULTS: The influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (-0.05; 95% confidence interval [CI], -0.11 to -0.00, per study wave) accelerated cognitive decline in young-old individuals, whereas frequent participation in SA at baseline (0.02; 95% CI, 0.01 to 0.03, per study wave) decelerated cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated cognitive decline in old-old individuals. CONCLUSIONS: Cognitive strategies based on modifiable lifestyle factors such as smoking cessation in young-old individuals and frequent SA participation in middle-old age individuals may have great potential for preventing cognitive decline. Because the influence of lifestyle factors varied by age group, age-specific approaches are recommended to promote cognitive health.

The Mediating Role of Social Participation in Motoric Cognitive Risk and its Relation to Depression and Loneliness in Older Adults.

BACKGROUND: Motoric cognitive risk syndrome (MCR) reduces the quality of life, independence, and social interaction in older adults. Social participation is a potentially modifiable factor that benefits cognitive and mental health. This study explored the mediating roles of social participation between MCR and depression and between MCR and loneliness. METHODS: We performed a secondary analysis of data from the 2015-2016 National Social Life, Health, and Aging Project. Slow gait speed and cognitive decline were used to assess MCR. Mediation analysis was applied to two models, both of which used MCR as an exposure and social participation as a mediator. The outcomes were depression and loneliness for each model, respectively. RESULTS: Among 1,697 older adults, 196 (11.6%) had MCR. The mediating role of social participation was statistically significant in both models. The indirect effect (ß=0.267, p=0.001) of MCR on depression through social participation comprised 11.97% of the total effect (ß=2.231, p<0.001). The indirect effect (ß=0.098, p=0.001) of MCR on loneliness through social participation was 19.48% of the total effect (ß=0.503, p<0.001). CONCLUSION: Interventions to increase social participation may reduce depression and loneliness of older adults with MCR.

Measurement Properties of the Stroke-Predischarge Occupational Therapy Assessment.

There is no comprehensive predischarge occupational therapy assessment tool in South Korea. The objective of this study was to determine Stroke-Predischarge Occupational Therapy Assessment (S-POTA) validity and reliability. Twenty-seven occupational therapists (OTs) assessed 97 patients with stroke. Concurrent validity was evaluated by comparing S-POTA scores with stroke-specific quality of life (SS-QOL). Discriminant validity was evaluated by comparing S-POTA scores between outpatient and readmitted groups, and a receiver operating characteristic analysis was conducted. The test-retest was conducted twice in 20 patients, and the inter-rater test was conducted with two OTs per patient. S-POTA positively correlated with SS-QOL. S-POTA rating differs significantly across outpatients and readmitted groups. All S-POTA areas under curve values ranged from .70 to .85, and cut-off points were derived. Cronbach's α for internal consistency was .953, the intraclass correlation coefficient for test-retest was .990, and .987 for inter-rater reliability. The results suggest S-POTA is a reliable tool for efficient implementation of discharge planning.

Effects of a time-use intervention in isolated patients with coronavirus disease 2019: A randomized controlled study.

OBJECTIVE: Patients with coronavirus disease experience deterioration in occupational balance and mental health. The primary objective of this study was to determine the effectiveness of a time-use intervention on the occupational balance of isolated patients with coronavirus disease. Its impact on secondary outcomes including mental health and quality of life was also assessed. METHODS: This randomized controlled clinical trial was conducted in a single community-based hospital. Forty-one patients (19 in the experimental group and 22 in the control group) with coronavirus disease were recruited between February 1, 2021, and March 19, 2021. Participants were randomly assigned to receive a time-use intervention or education on self-activity. The time-use intervention is to plan a daily routine to engage in meaningful occupations. It consisted of 4 steps: time-use analysis, occupation selection, arrangement of activities and practice, and occupational therapist intervention. The control group was educated on self-activity and spent time autonomously. OUTCOMES AND MEASURES: The primary outcome was occupational balance, evaluated using the Korean version of the Life Balance Inventory. Secondary outcomes were mental health and quality of life assessed using the Korean version of the Patient Health Questionnaire-9, Korean Form of Zung's Self-Rating Anxiety Scale, Korean version of the Insomnia Severity Index, Multidimensional State Boredom Scale-8, Fear of Coronavirus Disease: Korean version of the Fear of Coronavirus Disease Scale, and World Health Organization Quality of Life Assessment Instrument-BRIEF. Outcome measures were evaluated at admission and discharge. RESULTS: The time-use intervention significantly improved occupational balance (F = 14.12, p < .001) and all other measures of depression, anxiety, boredom, fear, and quality of life. Conversely, the control group showed a worsening pattern for all measures. CONCLUSION: The time-use intervention is effective for improving occupational balance, mental health, and quality of life in patients with coronavirus disease.

Current Status of Q Fever and the Challenge of Outbreak Preparedness in Korea: One Health Approach to Zoonoses.

Human Q fever, a zoonosis caused by Coxiella burnetii, presents with diverse clinical manifestations ranging from mild self-limited febrile illnesses to life-threatening complications such as endocarditis or vascular infection. Although acute Q fever is a benign illness with a low mortality rate, a large-scale outbreak of Q fever in the Netherlands led to concerns about the possibility of blood transfusion-related transmission or obstetric complications in pregnant women. Furthermore, a small minority (< 5%) of patients with asymptomatic or symptomatic infection progress to chronic Q fever. Chronic Q fever is fatal in 5-50% of patients if left untreated. In South Korea, Q fever in humans was designated as a notifiable infectious disease in 2006, and the number of Q fever cases has increased sharply since 2015. Nonetheless, it is still considered a neglected and under-recognized infectious disease. In this review, recent trends of human and animal Q fever in South Korea, and public health concerns regarding Q fever outbreaks are reviewed, and we consider how a One Health approach could be applied as a preventive measure to prepare for zoonotic Q fever outbreaks.

Predictive factors associated with trajectory of job satisfaction of workers with physical disabilities: A latent growth curve analysis.

BACKGROUND: Job satisfaction is a highly useful factor in maintaining a successful work life for the disabled. OBJECTIVE: This study aimed to evaluate how job satisfaction among workers with physical disabilities evolves over time, and to identify predictive factors that influence the trajectory of job satisfaction. METHODS: A longitudinal data analysis using the three-year databases of the 2016-2018 Employment Panel Survey for the Disabled (n = 693). A latent growth curve model analysis was conducted to determine the trajectory of the job satisfaction among workers with physical disabilities, as well as the predictive factors affecting it. RESULTS: Job satisfaction among workers with physical disabilities increased over time, and there were substantial individual differences in the trajectory of the job satisfaction. The significant predictors for the job satisfaction over the three years were degree of disability, computer usage ability, employment support services, and experience of discrimination. Gender, educational background, interpersonal relationship/organizational adaptability, convenience facilities for the disabled, job suitability, disability acceptability, and self-esteem had a considerable impact on the intercept of the job satisfaction, but not on the slope. CONCLUSION: The findings would inform healthcare providers to establish mid-to-long-term vocational rehabilitation intervention plans that could increase the job satisfaction among workers with physical disabilities.

Health-adjusted life expectancy according to lifestyle classified by the Yonsei Lifestyle Profile-BREF.

OBJECTIVES: This study aimed to investigate health-adjusted life expectancy (HALE) by demographic characteristics (sex, educational achievement, and residential area) according to the lifestyle classifications of the Yonsei Lifestyle Profile-BREF (YLP-BREF). METHODS: This study included 569 participants aged 55 years or older living in Korea. The YLP-BREF domains were physical activity, activity participation, and nutrition. RESULTS: Females had a longer HALE (mean±standard deviation, 8.90±5.06 years) in the physical activity domain, while males had a longer HALE in the nutrition domain (9.44±5.91 years). People living in rural areas had longer HALE in physical activity (12.02±5.60 years), activity participation (8.58±4.21 years), and nutrition (11.33±6.43 years). There were no significant differences according to sex or residential area. High school graduates showed the longest HALE (physical activity: 10.38± 6.89; activity participation: 7.64±4.29; nutrition: 9.59±6.40 years). There was a significant difference in educational achievement. CONCLUSIONS: As people age, the demand for a healthy lifestyle increases. This study attempted to calculate HALE by demographic characteristics according to lifestyle. The results of this study will help inform future research directions for providing a healthy lifestyle.

Item-level psychometrics of the Ascertain Dementia Eight-Item Informant Questionnaire.

The aim of this study is to evaluate the item-level psychometrics of the Ascertain Dementia Eight-Item Informant Questionnaire (AD-8) by examining its dimensionality, rating scale integrity, item fit statistics, item difficulty hierarchy, item-person match, and precision. We used confirmatory factor analysis and the Rasch rating scale model for analyzing the data extracted from the proxy versions of the 2019 and 2020 National Health and Aging Trends Study, USA. A total of 403 participants were included in the analysis. The confirmatory factor analysis with a 1-factor model using the robust weighted least squares (WLSMV) estimator indicated a unidimensional measurement structure (χ2 = 41.015, df = 20, p = 0.004; root mean square error of approximation = 0.051; comparative fit index = 0.995; Tucker-Lewis Index = 0.993;). The findings indicated that the AD-8 has no misfitting items and no differential item functioning across sex and gender. The items were evenly distributed in the item difficulty rating (range: -2.30 to 0.98 logits). While there were floor effects, the AD-8 revealed good reliability (Rasch person reliability = 0.67, Cronbach's alpha = 0.89). The Rasch analysis reveals that the AD-8 has excellent psychometric properties that can be used as a screening assessment tool in clinical settings allowing clinicians to measure dementia both quickly and efficiently. To summarize, the AD-8 could be a useful primary screening tool to be used with additional diagnostic testing, if the patient is accompanied by a reliable informant.

COVID-19 outbreak and risk factors for infection in a taekwondo gym in the Republic of Korea.

OBJECTIVES: Relatively few studies have assessed risk factors for coronavirus disease 2019 (COVID-19) in public facilities used by children and adolescents. This study presents an analysis of a COVID-19 outbreak that occurred in a taekwondo gym in Korea, predominantly among children and adolescents, with the aim of providing insights on managing COVID-19 outbreaks in similar facilities. METHODS: All 108 taekwondo gym students and staff received COVID-19 tests. A survey and closed-circuit television analyses were used to identify risk factors. A univariate analysis was conducted, followed by multivariate logistic regression analysis with backward elimination for variables with a significance level <0.10 in the univariate analysis. RESULTS: COVID-19 was confirmed in 30 of 108 subjects at the taekwondo gym (attack rate, 27.8%). The outbreak started in an adult class student. This student transmitted the virus to the staff, who consequently transmitted the virus to adolescent students. In the univariate analysis, the relative risk for younger age (≤9 years) was 2.14 (95% confidence interval [CI], 1.01-4.54; p=0.054), and that for food consumption inside the gym was 2.12 (95% CI, 1.04-4.30; p=0.048). In the multivariate logistic regression analysis, the odds ratio for younger age was 2.96 (95% CI, 1.07-8.20; p=0.036), and that for food consumption inside the gym was 3.00 (95% CI, 1.10-8.17; p=0.032). CONCLUSION: Food consumption inside the facility and young age were significant risk factors for COVID-19 transmission in this taekwondo gym. Food consumption should be prohibited in sports facilities, and infection prevention education for young students is also required.

An analysis of the factors affecting children and adolescent lifestyle in South Korea: A cross-sectional study with KCYPS 2018.

OBJECTIVE: The purpose of this study is to identify lifestyle factors that affect the subjective health conditions of adolescents in South Korea by utilizing data from the Korean Children's and Youth Panel Survey 2018 conducted in Korea. METHODS: This cross-sectional study used data from 4,490 students (2,399 students in the fourth grade of elementary school and 2,541 students in the first grade of middle school). The data obtained were evaluated using living time (sleep time, study time, leisure time), emotions (happiness, self-esteem, emotional problems), capabilities (cooperative attitude, grit), health (life satisfaction, exercise time, number of breakfasts, quality of sleep), media (smartphone use and dependence), school (school life satisfaction, relationship with friends and teachers), and home (time spent with parents, parenting attitude). RESULTS: We confirmed that regardless of grade, living time (leisure time), emotion (happiness, self-esteem, emotional problems), capabilities (grit), health (life satisfaction, exercise time, quality of sleep), media (smartphone dependence), and school (school life satisfaction, friendly, and teacher relations) are related to subjective health conditions. These results confirmed that evaluation parameters are related to subjective health conditions regardless of grade. CONCLUSION: This investigation revealed that the higher the quality of sleep enhanced positive emotions while increased exercise.

Seroepidemiologic evidence of Q fever and associated factors among workers in veterinary service laboratory in South Korea.

The incidence of Q fever has rapidly increased in South Korea since 2015. This study was undertaken to investigate the seroprevalence and seroreactivity of Q fever and the risk factors associated with its seroprevalence among workers in the veterinary service laboratory (VSL) in South Korea. This seroepidemiologic study was conducted in a total of 661 human subjects out of 1,328 subjects working in 50 VSL existing in South Korea between July 15 and July 29, 2019. Data were collected by administering survey questionnaires and by analyzing collected blood samples to determine the presence of antibodies against Coxiella burnetii. The seroprevalence and seroreactivity of C. burnetii infection were determined based on serum titers as (phase II IgG ≥1:256 and/or IgM ≥1:16) and (phase II IgG ≥1:16 and/or IgM ≥1:16) as determined by indirect immunofluorescent assay. Work, work environment, behavioral risk and protective factors associated with seroprevalence of Q fever were assessed by employing multivariable logistic regression analysis. Among the 661, the seroprevalence and seroreactivity of C. burnetii infection were 7.9% and 16.0%, respectively. Multivariate logistic regression analysis showed the risk factors significantly associated with seroprevalence were the antemortem inspection of cattle, goats, or sheep (APR (adjusted prevalence ratio), 2.52; 95% CI, 1.23-4.70)), animal blood splashed into or around eyes (APR, 2.24; 95% CI, 1.04-4.41), and contact with animals having Q fever (APR, 6.58; 95% CI, 3.39-10.85) during the previous year. This study suggests the need for precautions when contact with cattle, goats, or sheep is expected, especially during the antemortem inspection, when dealing with C. burnetii infected animals, or when there is a risk of ocular contact with animal derivatives. Therefore, we recommend the consistent use of appropriate personal protective equipment and other protective measures including PPE treatment and washing of body surfaces after work to prevent C. burnetii infections among VSL staff in South Korea.

Applying Latent Profile Analysis to Identify Lifestyle Profiles and Their Association with Loneliness and Quality of Life among Community-Dwelling Middle- and Older-Aged Adults in South Korea.

This study aimed to examine the multi-faceted lifestyle profiles of community-dwelling middle- and older-aged adults based on their physical activity, participation in various activities, and nutrition. It identified the association of lifestyle profiles with demographic variables, quality of life, and mental health. The analysis included 569 participants (mean age = 60.2; SD = 4.3). Latent profile analysis identified three distinctive lifestyle profiles: "inactive and unbalanced" (36.4%), "basic life maintenance" (54.6%), and "active and balanced" (9.1%). Sex (p < 0.001), age (p < 0.001), and regular medication intake (p < 0.01) were statistically significantly different among the three profiles. Of the "inactive and unbalanced" lifestyle group, 63.3% of it was comprised of by females, and a relatively large distribution was aged over 65. In the "basic life maintenance" subgroup, males showed a relatively large distribution, and 92.6% of participants were aged 55-64. People with active and balanced lifestyles demonstrated high quality of life levels (p < 0.001) and low loneliness levels (p < 0.01). Multinomial logistic regression revealed a statistically significant positive association between lifestyle profiles and quality of life (p < 0.001) as well as mental health (p < 0.01). Therefore, health promotion that considers multi-faceted lifestyle factors would need to improve health and quality of life among community-dwelling middle- and older-aged adults in South Korea.

Differences in Multi-Faceted Lifestyles in Response to the COVID-19 Pandemic and Their Association with Depression and Quality of Life of Older Adults in South Korea: A Cross-Sectional Study.

BACKGROUND: The World Health Organization declared COVID-19 a global pandemic on 11 March 2020, due to the number of newly reported confirmed cases and the rapid increase in deaths. Therefore, countries around the world limited their population to policies such as "social distancing" or "staying at home" to prevent the spread of the virus. The purpose of this study was to evaluate differences in lifestyle pre and post the outbreak COVID-19 among older adults in South Korea and to identify the impact of lifestyle differences on depression and quality of life. METHODS: An online single questionnaire covering sociodemographic data, lifestyle details, depression status, and quality of life level was distributed using mailing lists and social media. To assess lifestyles differences in older people pre and post the outbreak of COVID-19 pandemic, the online single questionnaire was used post COVID-19 pandemic. Based on the participants' memories, they responded lifestyles at two time points (pre and post COVID-19 pandemic). RESULTS: The results showed that there was a significant decrease in physical activity and activity participation during the pandemic. In terms of nutrition, there was no statistically significant change pre and post the outbreak COVID-19, except for the intake of protein, fat, and vitamins. Additionally, the results showed that the resulting lifestyle differences seem to have had a negative impact on depression and quality of life among older adults in South Korea. CONCLUSION: There was a significant difference the lifestyle patterns among the participants in South Korea between the current period and pre COVID-19 pandemic. Additionally, it is observed that these differenced lifestyles were associated with depression and quality of life among the participants. Our findings may help to develop public health programs that support healthy lifestyles in pandemic conditions.

Development and Validation of the Yonsei Lifestyle Profile-Satisfaction (YLP-S) Using the Rasch Measurement Model.

Lifestyle plays an important role in determining health and vitality among older adults. However, there is limited evidence regarding lifestyle assessment. This study examined the psychometric properties of the Yonsei Lifestyle Profile-Satisfaction (YLP-S). The participants in the study included 156 older adults. Rasch analysis was used to test unidimensionality, fit statistics, and the precision of the YLP-S. The YLP-S demonstrated a unidimensional measurement construct, and 18 items fit the Rasch model. The YLP-S illustrated reasonable precision (person strata = 5.37). Only 4 items showed differential item functioning by sex or age groups. The findings indicate that the YLP-S demonstrated sound internal validity and can be used by health professionals to measure the multifaceted lifestyle of older adults.

Seroprevalence and Factors Associated with Scrub Typhus Infection among Forestry Workers in National Park Offices in South Korea.

Scrub typhus is caused by the arthropod-borne bacterium Orientia tsutsugamushi and is an endemic infectious disease in the Asia-Pacific area. This study aimed to investigate the seroprevalence of scrub typhus and identify associated risk and protective factors among forestry workers, a neglected risk group for scrub typhus, in National Park Offices in South Korea. A nationwide cross-sectional serosurvey was carried out on 1945 National Park Office forestry workers (NPOFWs) in South Korea during December 2016. We visited 29 main offices and used a structured questionnaire to collect data regarding general characteristics, work activities, work hygiene-related factors, and other potential risk factors. Serum samples from NPOFWs were tested using indirect immunofluorescence assay to detect O. tsutsugamushi immunoglobulin (Ig) G and M antibodies. Of the 1945 NPOFWs, 718 (36.9%) participated in this cross-sectional study. The seroprevalence, defined as ≥1:256 for IgG and/or ≥1:16 for IgM, was 4.9% (35/718). In multivariate logistic analysis, longer duration of work in national parks (≥15 years; odds ratio (OR), 4.19; 95% confidence interval (CI), 1.71-10.28) and dry field farming (OR, 2.47; 95% CI, 1.12-5.46) were significantly associated with a higher risk of scrub typhus infection. Furthermore, the risk of scrub typhus infection was significantly lower among NPOFWs who washed working clothes daily (OR, 0.37; 95% CI, 0.18-0.75). This study indicated that scrub typhus is an important disease among NPOFWs in South Korea. Work hygiene, especially washing working clothes daily, needs to be emphasized among NPOFWs. Additionally, more precautions are required to diminish the rate of scrub typhus infection among NPOFWs who perform dry field farming.