The Impact of High Carbohydrate Intake on Physical Frailty in Older Korean Adults: a Cohort-based Cross-sectional Study

Background: The relationship between macronutrients and frailty is unclear. Previous studies have confirmed the relationships between energy and protein intake and physical frailty, while few studies have examined the role of carbohydrate or fat intake in the prevalence of frailty. The aim of this study is to investigate the relationship of energy and macronutrients with physical frailty in the Korean elderly population who had a high proportion of energy intake from carbohydrates.Methods: This study included 954 adults aged 70 to 84 years who have completed the assessment of frailty and 24-h recall upon enrolment in the Korean Frailty and Aging Cohort Study and have no extreme intake under 400 kcal (n = 2). The relationship between energy or macronutrients and frailty was evaluated using multivariate logistic regression models and multivariate nutrient density models.Results: In the subjects with low energy intake (odds ratio [OR] = 2.94, 95% confidence interval [CI] = 1.34–6.45) and total subjects (OR = 2.01, 95% CI = 1.03–3.93), consuming carbohydrates above the acceptable macronutrient distribution range (65% of energy) was related to a higher risk of frailty. Substituting the energy from fat with carbohydrates was related to a higher risk of frailty (1%, OR = 1.05, 95% CI = 1.00–1.09; 5%, OR = 1.26, 95% CI = 1.02–1.56; 10%, OR = 1.59, 95% CI = 1.03–2.43).Conclusions: This study showed that the proportion of energy intake from carbohydrates and fats may be an important nutritional intervention factor for reducing the risk of frailty.

Effects of Horticultural Therapy on Korean Elderly with Dementia: A Meta-analysis

Purpose: The aim of this meta-analysis was to identify the effects of horticultural therapy on Korean elderly with dementia.Methods: We searched the PubMed, EMBASE, Cochrane, CINAHL, and eight domestic databases, until February 2021. Data extraction and the risk of bias assessment were independently conducted by two authors. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis.Results: Of the 478 studies retrieved from the databases, 21 studies were included in the final analysis. A total of 93 outcome variables were analyzed in 21 literatures. The overall effect size of the horticultural treatment program was 0.91 (95% CI: 0.74~1.09, p<.001), which was statistically significant. Compared to the control group, horticultural therapy improved cognitive functions (SMD=0.71, 95% CI: 0.42~0.99, I2=79.9%), psychosocial functions (SMD=1.01, 95% CI: -0.70~1.31, I2=67.8%), and physical functions (SMD=1.05, 95% CI: 0.77~1.33, I2=72%) in Korean elderly with dementia.Conclusion: This meta-analysis found that horticultural therapy improved the cognitive, psychosocial, and physical functions of dementia patients compared to subjects in the control group.

Relationship between Cataract Surgery and Mortality in Elderly Patients with Cataract: Nationwide Population-Based Cohort Study in South Korea

We aimed to investigate the relationship between cataract surgery and all-cause and cause-specific mortality in Korean elderly patients with cataract using the Korean National Health Insurance Service-Senior cohort database. Elderly patients (≥60 years) diagnosed with cataract from 2002 through 2012 were included. The baseline characteristics included demographics and systemic and ocular comorbidities. Adjusted Cox regression models with time-varying covariates for cataract surgery were used to assess the relationship between cataract surgery and mortality. The study cohort included 241,062 patients, of whom 127,941 were in the cataract surgery group and 113,121 were in the cataract diagnosis group. The incidence of all-cause mortality was 3.62 deaths/100 person-years and 3.19 deaths/100 person-years in the cataract surgery and cataract diagnosis groups, respectively. Cataract surgery was associated with a decreased hazard of all-cause mortality after adjusting for demographics as well as systemic and ocular comorbidities (hazard ratio (HR), 0.93; p < 0.001). A protective association was noted between cataract surgery and mortality from vascular (HR, 0.92; p < 0.001) or neurologic (HR, 0.64; p < 0.001) causes. Patients with cataract who were 85 years of age and older, women, those who had lower income, and a Charlson comorbidity index score of 5 or more, or those without glaucoma revealed the largest reductions in mortality hazards resulting from cataract surgery.

Gender Differences In The Effects of Marital Status And Physical Activity On Depression Among The South Korean Elderly

Background: Depression in the elderly has recently drawn considerable attention as a public health issue because of its significant impact on the physical and social relationship of these individuals. We examined the association of physical activity and marital status with depression in the elderly and the related gender differences.Methods: This study used the data of the Korea National Health and Nutrition Examination Survey (KNHANES) of 2014, 2016, and 2018. The participants were 4,134 elderly individuals aged 65 years or older. The association of physical activity and marital status with depression was analyzed using logistic regression.Results: Out of 4,134 elderly participants, 318 had depression. Those not living with their spouse had higher prevalence of depression than those living with their spouse (women: odds ratio [OR] = 1.35, 95% CI = 1.01-1.82; men: OR = 1.89, 95% CI = 1.05-3.39). Moreover, spouseless elderly who engaged in physical activity was associated with depression (OR = 1.65, 95% CI= 1.04-2.62). In the case of elderly men, the risk of depression was 2.7 times higher for those who lived alone without a spouse and engaged physical activity.Conclusions: There was a gender difference in the association between marital status and depression, elderly men without spouses having higher risk of depression. Policymakers need to devise health programs and policies to encourage older men to engage in social activities after retirement.