Background: Depression in older adults is increasing worldwide with marital status and physical activity recognized as factors that influence depression among older adults. This study examines the association of marital status and physical activity with depressive symptoms in older adults. Methods: This study employed data collected by the Korea National Health and Nutrition Examination Survey (KNHANES) in 2014, 2016, and 2018. The respondents comprised 4,134 individuals aged 65 years or older. The study used logistic regression to analyze the association of physical activity and marital status to depressive symptoms. Results: Out of 4,134 respondents, 318 reported depressive symptoms. The study noted the risk of depressive symptoms was 1.39 times higher for those without a spouse than those with a spouse (women: odds ratio=1.39; 95% confidence interval=1.02-1.88). No association was found between physical activity and depressive symptoms. However, the risk of depressive symptoms was 1.75 times higher among physically active respondents without a spouse than those physically active with a spouse. In particular, the risk of depressive symptoms was approximately 2.57 times higher in physically active but spouseless men compared with the reference group, but the association is statistically nonsignificant. Conclusion: Although the study does not confirm a significant association between physical activity and depressive symptoms in older adults, it verifies that marital status exerts an impact on depressive symptoms among older adults. Therefore, future studies should establish standards for physical activity and examine the effects of appropriate physical activity on depression among older adults.

This study aims to analyze the relationship between cognitive function and out-of-pocket cost of the state change of multiple chronic conditions in individuals aged 60 or older. Data from the 2014 to 2018 Korean Longitudinal Study of Aging were used for 2202 older adults who were cognitively “normal” at the start of the survey. Four status change groups were established (“Good→ Good,” “Good→ Bad,” “Bad→ Good,” and “Bad→ Bad”) according to the change in the number of chronic diseases. Generalized estimating equation modeling analyzed the association between these changes and out-of-pocket medical cost. Out-of-pocket cost was significantly higher among older adults with multiple chronic conditions (p < 0.0001). Total out-of-pocket medical cost and out-of-pocket cost for outpatient care and prescription drugs were significantly higher for Bad→ Bad or Good→ Bad changes. Older adults with cognitive decline had significantly higher total out-of-pocket medical cost and out-of-pocket cost for prescription drugs. This study demonstrates the need to improve the multiple chronic conditions management construction model to enhance the health of older adults in Korea and secure national health care finances long-term. It provides a foundation for related medical and medical expenses-related systems.

Cardiovascular disease and cancer have increased the risk of mortality and morbidity in elderly persons worldwide. The aim of this study was to investigate the association of sedentary behavior and self-rated health with cardiovascular disease or cancer in elderly people. The data of 6785 elderly persons aged above 65 years from the Korea National Health and Nutrition Examination Survey 2014–2018 were examined. Binary logistic regression analyses assessed the association of sedentary behavior, self-rated health, and other risk factors with cardiovascular disease or cancer. Prolonged sedentary behavior in elderly people was associated with a high risk for cardiovascular disease (odds ratio (OR): 1.28, 95% confidence interval (CI): 1.08–1.52). There was a high risk for cardiovascular disease (OR: 2.36, 95% CI: 1.85–3.01) or cancer (OR: 1.48, 95% CI: 1.17–1.88) in elderly people who had poor self-rated health. This study identified the association between prolonged sedentary behavior and cardiovascular disease, and between poor self-rated health and cancer. Since prolonged sedentary behavior is related to cardiovascular disease, efforts are needed to reduce sedentary behavior hours and maintain good self-rated health.

OBJECTIVES: Previous studies have shown that people with multimorbidity have a higher risk of depression than those without multimorbidity. However, few studies have examined the association between depression and multimorbidity in men and women separately. Since the rates of depression and multimorbidity are different in men and women, it is necessary to examine whether gender differences affect their association.METHODS: This study included 30,138 participants (aged ≥ 65 years) from the National Survey of Older Koreans (2011-2017). Depression was defined using the Korean version of the Geriatric Depression Scale (SGDS-K). Multimorbidity was defined as people who had 2 or more chronic diseases, including arthritis, diabetes, heart disease, hypertension, pulmonary disease, cancer, stroke, or osteoporosis. Multiple logistic regression analysis was performed to determine the association between depression and multimorbidity.RESULTS: In total, 22.2% and 30.7% of men and women, respectively, had depression. Those with multimorbidity had a higher risk of depression than those without chronic conditions; specifically, the difference in risk among men was greater than that among women. Age was considered a moderator for women. While the effects of pulmonary disease, stroke, and cancer were especially substantial in the integrated analysis, gender differences were observed related to various chronic conditions comorbid with heart disease.CONCLUSIONS: There are gender differences in the association between multimorbidity and depression among older Korean adults. Therefore, gender-specific care should be provided to reduce depression in older adults with multimorbidity.

Objectives: The study aimed to investigate sex differences associated with sleep duration and the prevalence of thyroid disease among South Korean adults.Methods: This cross-sectional study included 17,555 adults who participated in the Korea National Health and Nutrition Examination Survey from 2016 to 2018. Sleep duration was categorized into three groups (insufficient, <7 hour; normal, 7-8 hour; prolonged, ≥9 hour). A chi-squared test was performed to assess baseline characteristics. Multiple logistic regression analysis was used to identify the association between general characteristic and the prevalence of thyroid disease. In subgroup analysis, multiple logistic regression analysis was performed to find the association between sleep duration and prevalence of thyroid disease by sex.Results: For men, insufficient and prolonged sleep durations were increased risk of thyroid disease compared with normal sleep duration (insufficient sleep: odds ratio, OR=1.85, 95% confidence interval, CI=1.19-2.87; prolonged sleep: OR=1.71, 95% CI=1.02-2.87).Conclusions: This study found that men with insufficient and prolonged sleep were associated with thyroid disease. Further studies are needed to identify the relationship between sleep duration, thyroid disease, and sleep quality by sex.