Epidemiology and Health

Most-read articles are from the articles published in 2022 during the last three month.

COVID-19: Cohort Profile

Cohort profile: investigating SARS-CoV-2 infection and the health and psychosocial impact of the COVID-19 pandemic in the Canadian CHILD Cohort: Rilwan Azeez, Larisa Lotoski, Aimée Dubeau, Natalie Rodriguez, Myrtha E. Reyna, Tyler Freitas, Stephanie Goguen, Maria Medeleanu, Geoffrey L. Winsor, Fiona S. L. Brinkman, Emily E. Cameron, Leslie Roos, Elinor Simons, Theo J. Moraes, Piush J. Mandhane, Stuart E. Turvey, Shelly Bolotin, Kim Wright, Deborah McNeil, David M. Patrick, Jared Bullard, Marc-André Langlois, Corey R. Arnold, Yannick Galipeau, Martin Pelchat, Natasha Doucas, Padmaja Subbarao, Meghan B. Azad; Epidemiol Health. 2023;45:e2023091. Published online October 13, 2023; DOI: https://doi.org/10.4178/epih.e2023091

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Abstract Summary PDF Supplementary Material: Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected all Canadian families, with some impacted differently than others. Our study aims to: (1) determine the prevalence and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among Canadian families, (2) identify predictors of infection susceptibility and severity of SARS-CoV-2, and (3) identify health and psychosocial impacts of the COVID-19 pandemic. This study builds upon the CHILD Cohort Study, an ongoing multi-ethnic general population prospective cohort consisting of 3,454 Canadian families with children born in Vancouver, Edmonton, Manitoba, and Toronto between 2009 and 2012. During the pandemic, CHILD households were invited to participate in the CHILD COVID-19 Add-On Study involving: (1) brief biweekly surveys about COVID-19 symptoms and testing; (2) quarterly questionnaires assessing COVID-19 exposure and testing, vaccination status, physical and mental health, and pandemic-driven life changes; and (3) in-home biological sampling kits to collect blood and stool. In total, 1,462 households (5,378 participants) consented to the CHILD COVID-19 Add-On Study: 2,803 children (mean±standard deviation [SD], 9.0±2.7 years; range, 0-17 years) and 2,576 adults (mean±SD, 43.0±6.5 years; range, 18-85 years). We will leverage the wealth of pre-pandemic CHILD data to identify risk and resilience factors for susceptibility and severity to the direct and indirect pandemic effects. Our short-term findings will inform key stakeholders and knowledge users to shape current and future pandemic responses. Additionally, this study provides a unique resource to study the long-term impacts of the pandemic as the CHILD Cohort Study continues.; Summary

Key Message
· This study of 1,462 Canadian families (5,378 individuals) leverages a decade of extensive pre-pandemic CHILD Cohort Study data to identify risk and resilience factors for susceptibility to the direct and indirect effects of the COVID-19 pandemic. · Our short-term findings will inform key stakeholders and knowledge users to shape current and future pandemic responses. · This study provides a unique resource to study the long-term impacts of the pandemic as the CHILD Cohort Study continues.

Brief Communication

Assessing the impact and implications of the revised Act on the Aggravated Punishment of Specific Crimes in preventing child traffic injuries in school zones in Korea: an interrupted time series analysis: Hong Jin Ku, Jin-Hwan Kim, Young June Choe, Seung Ah Choe, Mark R. Zonfrillo; Epidemiol Health. 2024;46:e2024032. Published online February 21, 2024; DOI: https://doi.org/10.4178/epih.e2024032

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Abstract Summary PDF: Abstract
In 2019, a child’s death in Korea led to legislation that imposed stricter penalties for school zone traffic violations. We assessed the impact of that legislation using 2017-2022 Traffic Accident Analysis System data. Adjusted analyses revealed a significant decline in severe injuries in school zones, decreasing from 11 cases to 8 cases per month (p=0.017). The legislation correlated with a reduced risk of all child traffic injuries (risk ratio, 0.987; 95% confidence interval, 0.977 to 0.997; p=0.002), indicating its efficacy in curbing accidents.; Summary

Korean summary
2019년 민식이법 도입 후 소아 교통사고에 미치는 영향을 평가하고자 하였다. 2017-2022 교통사고 분석 시스템 데이터를 통해 그 효과를 평가했고, 학군지역에서 심각한 부상이 월 평균 11건에서 8건으로 감소했다(p=0.017). 또한, 모든 어린이 교통사고 위험 비율도 감소했고(risk ratio, 0.987, 95% CI, 0.977-0.997; p=0.002), 사고 예방에 효과적임을 입증했다. 이 연구는 학군지역 어린이 안전에 법 조치의 긍정적 영향을 강조하며, 지속적인 도로 안전 강화의 중요성을 강조한다.

Key Message
Revised legislation in Korea, following a child’s tragic death, enforced stricter penalties for school zone traffic violations. Analysis of 2017-2022 data showed a significant decrease in severe injuries from 11 to 8 cases monthly (p=0.017). The legislation also reduced the risk of all child traffic injuries (risk ratio, 0.987; 95% CI, 0.977 to 0.997; p=0.002), demonstrating its effectiveness in preventing accidents. This study underscores the legislation’s positive impact on child safety in school zones, emphasizing the importance of ongoing enforcement efforts for road safety.

Special Article

The Korea National Disability Registration System: Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin; Epidemiol Health. 2023;45:e2023053. Published online May 11, 2023; DOI: https://doi.org/10.4178/epih.e2023053

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Abstract Summary PDF Supplementary Material

Abstract

The Korea National Disability Registration System (KNDRS) was established in 1989 to provide social welfare benefits based on predefined criteria for disability registration and an objective medical assessment using a disability grading system. Disability registration requires (1) a medical examination by a qualified specialist physician and (2) a medical advisory meeting to review the degree of disability. Medical institutions and specialists for the diagnosis of disabilities are legally stipulated, and medical records for a specified period are required to support the diagnosis. The number of disability types has gradually expanded, and 15 disability types have been legally defined. As of 2021, 2.645 million people were registered as disabled, accounting for approximately 5.1% of the total population. Among the 15 disability types, disabilities of the extremities account for the largest proportion (45.1%). Previous studies have investigated the epidemiology of disabilities using data from the KNDRS, combined predominantly with data from the National Health Insurance Research Database (NHIRD). Korea has a mandatory public health insurance system that covers the entire Korean population, and the National Health Insurance Services manages all eligibility information, including disability types and severity ratings. In short, the KNDRS-NHIRD is a significant data resource for research on the epidemiology of disabilities.

Summary

Korean summary
한국에서는 장애의 유형과 장애 유형별 장애정도를 장애인 복지법에서 규정하고 있다. 우리는 한국의 장애등록제도의 역사와 장애등록절차 그리고 장애유형별 통계 현황에 대해서 다루고자 한다.

Key Message
In Korea, the types and severity levels of disabilities are legally defined by the Korea National Disability Registration System (KNDRS). We address the history of the KNDRS, disability registration procedures, and current statistics.

Citations

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The link between disability and social participation revisited: Heterogeneity by type of social participation and by socioeconomic status
Jinho Kim, Gum-Ryeong Park, Eun Ha Namkung
Disability and Health Journal.2024; 17(2): 101543. CrossRef
Increased Risk of Dementia Following a Diagnosis of Hearing Impairment: A South Korean Nationwide Cohort Study
Minah Park, Sung-In Jang, Kyungduk Hurh, Eun-Cheol Park, Seung Hoon Kim
Journal of Alzheimer's Disease.2024; 97(2): 679. CrossRef
Risk of fracture among patients with spinal cord injury: A nationwide cohort study in South Korea
Seonghye Kim, Bongseong Kim, Kyung-Do Han, Junhee Park, Jung Eun Yoo, Hea Lim Choi, Won Hyuk Chang, In Young Cho, Dong Wook Shin
Bone.2024; 183: 117093. CrossRef
Desafios para inclusão de escolares com deficiência em um estado do brasileiro
Paola Regina Martins Bruno, Graziane Pacini Rodrigues, Damarys Paula Alves Alvim, Francisco Winter dos Santos Figueiredo, Janeisi de Lima Meira, Andreia de Bem Machado, Gabriel Martins Cabral, Fernando Rodrigues Peixoto Quaresma
Cuadernos de Educación y Desarrollo.2024; 16(4): e3840. CrossRef
Korean autistic persons facing systemic stigmatization from middle education schools: daily survival on the edge as a puppet
Wn-ho Yoon, JaeKyung Seo, Cheolung Je
Frontiers in Psychiatry.2024;[Epub] CrossRef
Disability acceptance and depressive symptoms: the moderating role of social support
Gum-Ryeong Park, Sujeong Park, Jinho Kim
Disability and Rehabilitation.2024; : 1. CrossRef
Impact of a Service-Learning Program Using Soccer Training on the Emotional and Behavioral Problems of Children with Developmental Disabilities
Huan Meng, Yonghwan Kim, Kyujin Lee
Children.2024; 11(4): 467. CrossRef
Risk of Heart Disease in Patients With Amputation: A Nationwide Cohort Study in South Korea
Hea Lim Choi, Jung Eun Yoo, Miso Kim, Bongsung Kim, Junhee Park, Won Hyuk Chang, Heesun Lee, Kyungdo Han, Dong Wook Shin
Journal of the American Heart Association.2024;[Epub] CrossRef
Fracture Risk Among Stroke Survivors According to Poststroke Disability Status and Stroke Type
Dagyeong Lee, In Young Cho, Won Hyuk Chang, Jung Eun Yoo, Hea Lim Choi, Junhee Park, Dong Wook Shin, Kyungdo Han
Stroke.2024; 55(6): 1498. CrossRef
Disparities in the diagnosis and treatment of colorectal cancer among patients with disabilities
Ki Bae Kim, Dong Wook Shin, Kyoung Eun Yeob, So Young Kim, Joung-Ho Han, Seon Mee Park, Jong Heon Park, Jong Hyock Park
World Journal of Gastrointestinal Oncology.2024; 16(7): 2925. CrossRef
Increased Risk of Fracture after Traumatic Amputation: A Nationwide Retrospective Cohort Study
Hyeonjin Cho, Junhee Park, Bongseong Kim, Kyungdo Han, Hea Lim Choi, Dong Wook Shin
Healthcare.2024; 12(13): 1362. CrossRef
Trends in Physiotherapy Interventions and Medical Costs for Parkinson’s Disease in South Korea, 2011–2020
Dong-Woo Ryu, Jinse Park, Myung Jun Lee, Dallah Yoo, Sang-Myung Cheon
Journal of Movement Disorders.2024; 17(3): 270. CrossRef
COVID-19 and Neurodevelopmental Delays in Early Childhood: A Longitudinal Analysis of Developmental Outcomes in Korean Children
Youn Young Choi, Kyung-Shin Lee, Seul Gi Park, You Sun Kim, Jeehye Lee, Ho Kyung Sung, Myoung-hee Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Risk of depression in amyotrophic lateral sclerosis: A nationwide cohort study in South Korea
Soonwook Kwon, Bongseong Kim, Kyung-Do Han, Wonyoung Jung, Eun Bin Cho, Dong Wook Shin, Ju-Hong Min
Journal of Psychiatric Research.2024; 178: 414. CrossRef
Association between glycemic status and all-cause mortality among individuals with dementia: a nationwide cohort study
Youn Huh, Kye-Yeung Park, Kyungdo Han, Jin-Hyung Jung, Yoon Jeong Cho, Hye Soon Park, Ga Eun Nam, Soo Lim
Alzheimer's Research & Therapy.2024;[Epub] CrossRef
Increased risk of Parkinson's disease amongst patients with age‐related macular degeneration and visual disability: A nationwide cohort study
Je Moon Yoon, Dong Hui Lim, Jinyoung Youn, Kyungdo Han, Bong Sung Kim, Wonyoung Jung, Yohwan Yeo, Dong Wook Shin, Don‐Il Ham
European Journal of Neurology.2023; 30(9): 2641. CrossRef

Data Profile

The Korea National Health and Nutrition Examination Survey data linked Cause of Death data: Sungha Yun, Kyungwon Oh; Epidemiol Health. 2022;44:e2022021. Published online February 9, 2022; DOI: https://doi.org/10.4178/epih.e2022021

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Abstract Summary PDF Supplementary Material

Abstract

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey that is conducted annually to assess the health and and health-related behaviors of Korean population. To utilize KNHANES data to studies of mortality risk factors, the Korea Disease Control and Prevention Agency (KDCA) constructed a database linking KNHANES data to cause-of-death statistics in Statistics Korea, made available to researchers since 2020. The KNHANES data were linked to the Cause of Death Statistics based on resident registration numbers for subjects aged 19 years or older who agreed to link the data. The linkage rate between 2007-2015 National Health and Nutrition Examination Survey and 2007-2019 Cause of Death Statistics was 97.1%. In the linked dataset, the total death rate was 6.6%, of which neoplasms accounted for the highest death rate (32.1%), followed by circulatory system disease (22.7%) and respiratory system disease (11.5%). The linked dataset was made available through the Research Data Center of the KDCA after a review of the research proposal, and will be made available after periodical updates.

Summary

Korean summary
1. 국민건강영양조사 자료가 사망 위험요인 규명 연구에 활용되도록 통계청의 사망원인통계와 연계자료 구축함 2. 2007~2015년 국민건강영양조사와 2007~2019년 사망원인통계의 연계율은 97.1%이었음 3. 국민건강영양조사-사망원인통계 연계자료는 2020년부터 연구자에게 질병관리청 내 학술연구자료처리실를 통해 제공되고 있음

Key Message
1. To utilize the Korea National Health and Nutrition Examination Survey (KNHANES) data to studies of mortality risk factors, the data were linked to the Cause of Death Statistics in the Statistics Korea. 2. The linkage rate between the 2007-2015 KNHANES and the 2007-2019 Cause of Death Statistics was 97.1%. 3. The Korea National Health and Nutrition Examination Survey data linked Cause of Death data have been provided to researchers through the Research Data Center in the Korea Disease Control and Prevention Agency (KDCA) since 2020.

Citations

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Chronic Disease Patterns and Their Relationship With Health-Related Quality of Life in South Korean Older Adults With the 2021 Korean National Health and Nutrition Examination Survey: Latent Class Analysis
Mi-Sun Lee, Hooyeon Lee
JMIR Public Health and Surveillance.2024; 10: e49433. CrossRef
Toloese Generates Nitric Oxide through Natural Radiation of Far Infrared Rays, Reducing Serum Glucose, Cholesterol, and Triglycerides
Min-Ho Yeo, Young-Hyeon Lee, Mi-Jin Ryu, Yong-Hak Choi, Hye-Sook Kim, Kyung-Soo Chang
Healthcare.2024; 12(12): 1227. CrossRef
Risk of all-cause mortality is associated with multiple health-related lifestyle behaviors and does not differ between urban and rural areas in Korea
Seunghee Kim, Clara Yongjoo Park
Nutrition Research and Practice.2024; 18(4): 554. CrossRef
Association of resting heart rate and physical activity with cardiovascular mortality: A population-based cohort study of Korean adults
Younghwan Choi, Geonhui Kim, Jiyeon Yoon, Yeon Soo Kim
Journal of Sports Sciences.2024; 42(16): 1529. CrossRef
Computational method of the cardiovascular diseases classification based on a generalized nonlinear canonical decomposition of random sequences
Igor Atamanyuk, Yuriy Kondratenko, Valerii Havrysh, Yuriy Volosyuk
Scientific Reports.2023;[Epub] CrossRef
The Association between Advanced Liver Fibrosis and Mortality Is Modified by Dietary Quality among Korean Adults: Results from the Korea National Health and Nutrition Examination Survey with Mortality Data
Juhee Lee, Garam Jo, Dahyun Park, Hee Ju Jun, Jae Hyun Bae, Min-Jeong Shin
Nutrients.2023; 15(6): 1501. CrossRef
Association of dietary sodium intake with impaired fasting glucose in adult cancer survivors: A population-based cross-sectional study
Kyuwoong Kim, Hamee Kim, Tae Joon Jun, Young-Hak Kim, Dong Keon Yon
PLOS ONE.2023; 18(5): e0286346. CrossRef
Fibrosis-4 Index Predicts Long-Term All-Cause, Cardiovascular and Liver-Related Mortality in the Adult Korean Population
Young-Gyun Seo, Stergios A. Polyzos, Kyung-Hee Park, Christos S. Mantzoros
Clinical Gastroenterology and Hepatology.2023; 21(13): 3322. CrossRef
The serotype-specific prevalence of pneumococci in hospitalized pneumonia patients with COPD: a prospective, multi-center, cohort study
Jae Yeol Kim, Jae-Woo Jung, Min-Jong Kang, Deog Kyeom Kim, Hayoung Choi, Young-Jae Cho, Seung Hun Jang, Chang-Hoon Lee, Yeon Mok Oh, Ji Sook Park
The Korean Journal of Internal Medicine.2023; 38(5): 714. CrossRef
The Korea Cohort Consortium: The Future of Pooling Cohort Studies
Sangjun Lee, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Sun Ha Jee, Aesun Shin, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Daehee Kang, Keun-Young Yoo, Sue K. Park
Journal of Preventive Medicine and Public Health.2022; 55(5): 464. CrossRef
Self-perceived Weight and Mortality in Korean Adults Based on the Korea National Health and Nutrition Examination Survey Data Linked to Cause of Death Statistics
Kayoung Lee
Journal of Obesity & Metabolic Syndrome.2022; 31(4): 313. CrossRef

Systematic Review

The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis: Phei Nie Yau, Clairen Jia Ern Foo, Nicholas Li Jie Cheah, Kar Foong Tang, Shaun Wen Huey Lee; Epidemiol Health. 2022;44:e2022058. Published online July 12, 2022; DOI: https://doi.org/10.4178/epih.e2022058

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320 Download
15 Web of Science
19 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region.

METHODS

A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis.

RESULTS

Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life.

CONCLUSIONS

Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.

Summary

Key Message
Highly common and disabling among older adults in ASEAN region, functional disability limits the ability to carry out activities of daily living, and markedly reduces life quality.

Citations

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Association of objectively measured physical activity with incidence disability in older adults with/without social isolation
Masanori Morikawa, Kenji Harada, Satoshi Kurita, Kazuya Fujii, Chiharu Nishijima, Daisuke Kakita, Hiroyuki Shimada
Archives of Gerontology and Geriatrics.2024; 120: 105338. CrossRef
Sedentary behavior and the combination of physical activity associated with dementia, functional disability, and mortality: A cohort study of 90,471 older adults in Japan
Zhen Du, Koryu Sato, Taishi Tsuji, Katsunori Kondo, Naoki Kondo
Preventive Medicine.2024; 180: 107879. CrossRef
Household Environments and Functional Decline Among Middle-Aged and Older Adults in China: Variations by Gender, Age, and Residence
Dandan Zhao, Ye Luo, Karen A. Kemper, Lingling Zhang, Xi Pan
Research on Aging.2024; 46(9-10): 451. CrossRef
Estimating the prevalence of intrinsic capacity decline: A systematic review and meta-analysis using WHO's integrated care of older people (ICOPE) screening tool
Vinothini Jayaraj, Sridevi Gnanasekaran, Yazhini VB, Mohanraj Palani Selvam, Navin Rajendran, Gitashree Dutta, Tarun Kumar, Chandrashekar Babu, Vinoth Rajendran
Archives of Gerontology and Geriatrics Plus.2024; 1(3): 100032. CrossRef
Functional disability among the older adult population in Kedah, Malaysia
Ganesh Pandian Balasubramanian, Saraswathi Simansalam, Sireesha Paruchuri, Lydia Lu Qing Yi, Jun Hao Chui
Clinical Epidemiology and Global Health.2024; 29: 101673. CrossRef
Time-varying lifestyle and mental-ill health risk factors for the longitudinal development of daily activity limitations among middle-aged and older adults in Thailand
Dararatt Anantanasuwong, Supa Pengpid, Karl Peltzer
Translational Medicine of Aging.2024; 8: 20. CrossRef
The impact of social isolation on functional disability in older people: A multi-cohort study
Eric Tsz-Chun Lai, Anson Kai Chun Chau, Irene Yuk-Ying Ho, Hideki Hashimoto, Chang-Yup Kim, Tung-Liang Chiang, Ya-Mei Chen, Michael Marmot, Jean Woo
Archives of Gerontology and Geriatrics.2024; 125: 105502. CrossRef
Association between masticatory function, frailty, and functional disability: an observational study
Hiroko Furuhashi, Takanori Honda, Yoshihiko Furuta, Shoko Tomooka, Takahiro Tajimi, Yasumi Kimura, Daigo Yoshida, Toshiharu Ninomiya
BMC Geriatrics.2024;[Epub] CrossRef
Association between the incidence of functional disability and frequency of eating together among older adults living alone: a 6-year follow-up study from the Japan Gerontological Evaluation Study
Akio Shimizu, Takaaki Ikeda, Yasuhiro Miyaguni, Sho Takeda, Yudai Tamada, Jun Aida
Age and Ageing.2024;[Epub] CrossRef
Sedentary Behavior, Obesity, and Disabilities in Community-Dwelling Older Adults: Analysis of the Brazilian National Health Survey 2019
Bruno Prates Freitas, Letícia Martins Cândido, Katia Jakovljevic Pudla Wagner, Ana Cristina Rodrigues Lacerda, Vanessa Amaral Mendonça, Roberta De Micheli, Alessandro Sartorio, Núbia Carelli Pereira de Avelar, Ana Lúcia Danielewicz
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The prevalence of disability in older adults with multimorbidity: a meta-analysis
Jin Zhang, Yan Sun, Aiying Li
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Concentrated disadvantage and functional disability: a longitudinal neighbourhood analysis in 100 US cities
Daniel Semenza, Ian Silver, Richard Stansfield, Courtney Boen
Journal of Epidemiology and Community Health.2023; 77(10): 676. CrossRef
Functional disability and associated factors in older adults seen at a primary health care unit
Paulo José Cortez, Paulo Eduardo Aliaga da Silveira, Beatriz Carvalho, João Vitor Medeiros de Abreu, Yan Lyncon, Gerson Souza Santos, Luciano Magalhães Vitorino
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Suitable ultrasound screening method for older adults with disability to identify low muscle mass
Huaying Ding, Xia Lin, Sha Huang, Jie Liao, Zhouyu Li, Lanlan Chen, Li Zhu, Yukuan Xie, Qian Nie, Xiaoyan Chen
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Unmet needs for care for activities of daily living among older adults with functional disabilities in Vietnam
Phong Manh Phi, Long Thanh Giang, Tham Thi Hong Pham
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Frailty but not low muscle quality nor sarcopenia is independently associated with mortality among previously hospitalized older adults: A prospective study
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A cross-sectional study for assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district
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Mental distress and incident functional disability among a rural ageing population in South Africa
Supa Pengpid, Karl Peltzer
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Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand
Supa Pengpid, Karl Peltzer, Dararatt Anantanasuwong
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Special Article

Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis: Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park; Epidemiol Health. 2023;45:e2023092. Published online October 16, 2023; DOI: https://doi.org/10.4178/epih.e2023092

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452 Download
3 Web of Science
3 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis.

METHODS

Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.

RESULTS

Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males.

CONCLUSIONS

Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.

Summary

Korean summary
본 연구는 코호트 연구를 기반으로 하여 음주의 수준에 따른 암 위험 연관성에 대해 체계적 문헌고찰(139편)과 메타분석(106편)을 수행하였다. 연구 결과, 음주와 암 위험 사이에 용량-반응 관계가 나타났으며, 소량의 음주는 암 유형에 따라 차이가 있었으나, 식도암, 대장암, 전립선암(남성), 유방암(여성)에서 암 위험과의 연관성이 있음을 발견했다. 따라서, 암 위험 측면에서 음주에 안전한 수준이 없음을 시사하며, 음주와 관련된 잠재적 피해를 완화하기 위해서는 음주 지침 강화와 같은 공중보건개입이 필요하다.

Key Message
The aim of this study was to assess the relationship between different levels of alcohol consumption and the risk of various cancer types through a systematic review and meta-analysis, providing insights into the ongoing debate about alcohol consumption and cancer causality. The findings support a dose-response relationship between alcohol consumption levels and cancer risk and the light alcohol consumption was associated with risks of esophageal, colorectal, prostate (male), and breast (female) cancer. These results emphasize the absence of a safe threshold for alcohol consumption in terms of cancer risk.

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COVID-19: Original Article

Depression, anxiety, and stress in Korean general population during the COVID-19 pandemic: Hooyeon Lee, Dongwoo Choi, Jung Jae Lee; Epidemiol Health. 2022;44:e2022018. Published online January 18, 2022; DOI: https://doi.org/10.4178/epih.e2022018

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Abstract Summary PDF

Abstract

OBJECTIVES
The aim of this study was to investigate the prevalence and risk factors of poor mental health in the general Korean population during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

This cross-sectional, population-based, online survey-based study was conducted from November 5 to 20, 2020 and included adults aged 20-49 years in Chungnam Province, Korea. A total of 549 adults were included.

RESULTS

In total, 18.8% of the participants had symptoms of depression, 10.6% had symptoms of anxiety, and 5.1% had a high level of perceived stress during the COVID-19 pandemic. Higher levels of stress (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.13 to 8.67), anxiety (OR, 2.33; 95% CI, 1.09 to 4.49), and depression (OR, 3.00; 95% CI, 1.64 to 5.50) were found among never married, widowed, divorced, and separated people than among married/cohabiting/partnered participants. Participants who felt increased stress at home during the COVID-19 outbreak reported more depression (OR, 2.45; 95% CI, 1.49 to 4.05) and anxiety (OR, 2.42; 95% CI, 1.31 to 4.50). Women had higher risks of anxiety (OR, 1.97; 95% CI, 1.09 to 3.58) and stress (OR, 6.40; 95% CI, 2.30 to 17.85) than men. Participants with the highest household income were less likely to report symptoms of stress than those with the lowest household income (OR, 0.24; 95% CI, 0.06 to 0.96).

CONCLUSIONS

The participants in this study exhibited poor mental health index scores, suggesting that some people are at risk for mental health problems during the COVID-19 pandemic. Being married was independently and significantly associated with a lower likelihood of depression, anxiety, and stress.

Summary

Korean summary
이 연구는 코로나-19 유행 기간 동안 정신건강 현황과 위험 요인을 알아보기 위한 단면연구이다. 코로나 19 유행 이후 가정내 스트레스가 증가했다고 응답한 경우 우울증과 불안감의 유병률이 높았다. 반면, 남성인 경우, 결혼했거나 동거인과 같이 살고 있는 경우에는 우울증, 불안 또는 스트레스의 유병률이 통계적으로 유의하게 낮았다. 마스크 착용하기, 비대면 활동 증가, 또는 사회적 거리두기 등 코로나 19의 유행을 통제하기 위한 많은 정책은 개인의 일상생활과 정신건강에 많은 영향을 미쳤다. 이 연구는 취약 집단을 발굴하고, 정신건강 회복을 위한 전략을 개발하는데 기초자료를 제공할 수 있다.

Key Message
This study revealed high prevalence rates of depression, anxiety, and stress in the general population of Korea aged 20-49 years during the COVID-19 pandemic. Participants who felt increased stress at home reported more depression and anxiety. Men and being married were significantly associated with a lower likelihood of depression, anxiety, or stress. The COVID-19 pandemic has been a traumatic event. In addition, the policies created to prevent its spread have disrupted daily living for the general population. Implementing strategies to promote resilience and support psychologically vulnerable individuals during the COVID-19 crisis is of fundamental importance.

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Methods

Expansion of a food composition database for the food frequency questionnaire in the Korean Genome and Epidemiology Study (KoGES): a comprehensive database of dietary antioxidants and total antioxidant capacity: Jiseon Lee, Ji-Sook Kong, Hye Won Woo, Mi Kyung Kim; Epidemiol Health. 2024;46:e2024050. Published online May 10, 2024; DOI: https://doi.org/10.4178/epih.e2024050

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study constructed a comprehensive database of dietary antioxidants and total antioxidant capacity (TAC) to facilitate the estimation of daily antioxidant intake using a food frequency questionnaire (FFQ). This database was applied to 3 general population-based cohorts (n=195,961) within the Korean Genome and Epidemiology Study (KoGES).
METHODS
To establish a database of 412 foods derived from recipes of a 106-item FFQ, we followed a pre-established standardized protocol. This included the selection of source databases, matching of foods, substitution of unmatched items with identical foods and input of values, and assessment of coverage. For each food, the TAC was estimated by summing the individual antioxidant capacities, calculated by multiplying the amount of each antioxidant by its vitamin C equivalent antioxidant capacity.
RESULTS
We identified 48 antioxidants across 5 classes: retinol, carotenoids, vitamins C and E, and flavonoids, with flavonoids divided into 7 subclasses. TAC values were then established. Coverage exceeded 90.0% for retinol, carotenoids, vitamin C, and vitamin E, while coverage for flavonoids was 60.9%. The daily intakes of 4 antioxidant classes—all but vitamin E—were higher in women than in men. The Ansan-Ansung cohort exhibited the highest levels of dietary TAC, vitamin E, and flavonoids, while the Health Examinees Study cohort displayed the highest values for retinol, carotenoids, and vitamin C.
CONCLUSIONS
We customized a comprehensive antioxidant database for the KoGES FFQ, achieving relatively high coverage. This expansion could support research investigating the impact of dietary antioxidants on the development of chronic diseases targeted by the KoGES.; Summary

Korean summary
본 연구는 한국인유전체역학조사사업(KoGES) 식품섭취빈도조사(FFQ)에 특화된 항산화 데이터베이스를 확장하여 개발한 첫 번째 연구로, 48종의 항산화제와 TAC 값을 포함하여 기존 연구의 부족한 부분을 채웠습니다. 코호트 별로 식이 항산화제 섭취량에서 큰 차이가 나타났으며, 지역사회 기반 코호트에서는 비타민 E와 플라보노이드 섭취가 가장 높았고, 도시 기반 코호트에서는 레티놀, 카로티노이드, 비타민 C 섭취에서 가장 높았습니다. 반면, 농촌 기반 코호트에서는 대부분의 항산화제 섭취량이 가장 낮았습니다. 또한 성별, 연령, 및 교육 수준에 따른 섭취량의 차이도 확인되었으며, 주로 여성, 젊은 연령층, 그리고 교육 수준이 높은 사람들이 더 많은 항산화제를 섭취한 반면, 고령자와 흡연자는 섭취량이 적게 나타났습니다.

Key Message
This study is the first to develop an expanded antioxidant database specifically for the Korean Genome and Epidemiology Study (KoGES) FFQ, addressing a critical gap in research by including a broad range of 48 antioxidants and total antioxidant capacity (TAC). Significant differences in dietary antioxidant intake were observed across different cohorts, with participants in the Ansan and Ansung (ASAS) study consuming the most vitamin E and flavonoids, while those in the Health Examinee (HEXA) study had the highest intake of retinol, carotenoids, and vitamin C. In contrast, the Cardiovascular Disease Association Study (CAVAS) showed the lowest intake of most antioxidants. Demographic differences were also evident, with women, younger individuals, and those with higher education levels consuming more antioxidants, while older adults and smokers consumed less.

Original Article

Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults: Inkyung Baik, Nan Hee Kim, Seong Hwan Kim, Chol Shin; Epidemiol Health. 2023;45:e2023055. Published online June 8, 2023; DOI: https://doi.org/10.4178/epih.e2023055

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk.

METHODS

This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression.

RESULTS

Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years.

CONCLUSIONS

BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.

Summary

Korean summary
본 역학 연구는 한국 성인 8,901명을 연구대상자로 하여 기초조사에서 세가지 자세, 즉 앉은 자세, 누운 자세, 일어선 자세에서 혈압을 측정하고, 이후 10년 동안의 사망 여부를 추적조사하여, 측정 자세에 따른 혈압과 사망 위험과의 관련성을 분석하였다. 그 결과, 누운 자세에서 측정된 고혈압(기준: 수축기 혈압이 140 mmHg 이상 혹은 이완기 혈압이 90 mmHg 이상)인 사람은 정상 혈압(기준: 수축기 혈압이 120 mmHg 미만이고 이완기 혈압이 80 mmHg 미만)인 사람에 비해 36%(1단계 고혈압) 혹은 59%(2단계 고혈압) 가량 총 사망 위험이 유의적으로 증가하는 것으로 나타났다. 이에 비해, 앉은 자세 및 일어선 자세에서 측정, 정의된 고혈압은 총 사망 위험을 증가시켰지만 유의적인 결과를 나타내지 못했다. 추후 연구에서 재확인이 필요하지만, 본 연구 결과가 시사하는 바는 앉은 자세나 일어선 자세보다 누운 자세에서 측정하는 혈압이 총 사망 위험을 더 잘 예측하므로, 고혈압 진단 외의 추가적인 활용 가능성이 있는 것으로 평가된다.

Key Message
The current epidemiological study revealed that blood pressure measured in a supine position could predict all-cause mortality and cardiovascular mortality better than blood pressure measured in a sitting or standing position. As a result, blood pressure measurements in a supine position may be useful in assessing mortality risk.

Citations

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COVID-19: Special Article

Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey: Ga Bin Lee, Yoonjung Kim, Suyeon Park, Hyeon Chang Kim, Kyungwon Oh; Epidemiol Health. 2022;44:e2022041. Published online April 25, 2022; DOI: https://doi.org/10.4178/epih.e2022041

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population.

METHODS

Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment).

RESULTS

Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively).

CONCLUSIONS

An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.

Summary

Korean summary
한국인의 비만, 고혈압, 당뇨 및 고지혈증 유병률은 지난 10년간 전반적으로 증가하는 경향을 보였다. 특히, 코로나 19가 유행한 2020년에 남성의 주요 만성질환 유병률은 지난 3년 평균치와 비교하였을 때 모두 유의하게 증가하였다. 반면, 여성에서 만성질환 유병률의 뚜렷한 증가는 관찰되지 않았다.

Key Message
During COVID-19 pandemic, the overall increase in major chronic diseases was observed in Korean adults, and this trend was prominent in men. Accordingly, target-specific intervention strategies need to be developed to reduce the burden of cardiovascular and metabolic diseases in the future.

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COVID-19: Special Article

Mental health of Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey: Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim; Epidemiol Health. 2022;44:e2022042. Published online April 25, 2022; DOI: https://doi.org/10.4178/epih.e2022042

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Coronavirus disease 2019 (COVID-19) and the associated social distancing, limited freedom, and fear of an uncertain future are expected to have substantial mental health effects. We investigated mental health responses in the community during the first year of the COVID-19 pandemic in Korea.

METHODS

We used 2016-2019 and 2020 data from the Korea National Health and Nutrition Examination Survey (KNHANES) to assess pre-pandemic and pandemic mental health status, respectively, in terms of perceived severe stress, depression, and suicidal plans. All analyses were gender-stratified. Pre-specified subgroup analyses were performed according to age, employment status, and household income.

RESULTS

The percentage of Korean adults with suicidal plans increased significantly from 1.3%p (95% confidence interval [CI], 1.1 to 1.5) in 2016-2019 to 1.8%p (95% CI, 1.4 to 2.1) in 2020. Individuals in their 20s and 40s showed a marked increase in suicidal plans (1.2%p; 95% CI, 0.0 to 2.3 and 0.9%p; 95% CI, 0.0 to 1.8, respectively). In men, depression and perceived severe stress increased significantly from pre-COVID-19 to 2020. There was a 2.4%p (95% CI, 0.8 to 4.0) increase in depression among standard workers and a 2.9%p increase in depression in individuals in the second-highest quintile of household income from 2016 and 2018 to 2020.

CONCLUSIONS

As COVID-19 continued, mental health issues such as suicidal plans, depression, and severe stress increased significantly in young men and people in the second-highest quintile of household income. Proactive community mental health efforts are needed to prevent increases in the suicide rate resulting from prolonged exposure to the COVID-19 pandemic.

Summary

Korean summary
코로나19 이전에 비해 코로나19 유행 첫 해 동안에 전체 인구에서 자살 계획 유병율이 유의하게 증가하였고 특히 20대-40대에서 증가 비율이 높았다. PHQ-9으로 측정한 우울증 유병율은 전체 남성에서 증가하였고 특히 30대 남성에서 증가 비율이 높았다. 코로나19 영향으로 자살 계획과 우울증과 같은 정신 건강 문제가 젊은 성인에서 크게 증가하였기 때문에 이러한 정신건강 문제가 자살률 증가로 이어지는 것을 방지하기 위해 국가적 차원의 체계적인 정책과 적극적인 지역사회 정신건강 중재가 필요하다.

Key Message
There was a significant increase in the prevalence of suicidal plan in the overall population during the first year of COVID-19 pandemic compared to pre-COVID-19. In particular, suicide plans increased among those in their 20s and 40s. The prevalence of PHQ-9 detected depression increased in all men, especially among men in their 30s. As mental health problems such as suicide planning and depression have significantly increased among young adults due to the impact of COVID-19, systematic policies at the national level and active community mental health interventions are needed to prevent these mental health problems from leading to an increase in suicide rates.

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Special Article

Nutrition survey methods and food composition database update of the Korean Genome and Epidemiology Study: Seon-Joo Park, Jieun Lyu, Kyoungho Lee, Hae-Jeung Lee, Hyun-Young Park; Epidemiol Health. 2024;46:e2024042. Published online April 2, 2024; DOI: https://doi.org/10.4178/epih.e2024042

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Abstract Summary PDF Supplementary Material

Abstract

This study presents the nutrition survey methods and the updated food composition database for the Korean Genome and Epidemiology Study (KoGES). The KoGES, which is the largest and longest cohort study in Korea, aims to identify genetic and environmental factors associated with chronic diseases. This study has collected dietary data using a validated semi-quantitative food frequency questionnaire and/or the 24-hour recall method. However, these dietary survey methods use different food composition databases, and their nutritional values are out of date. Therefore, it became necessary to update the food composition database by revising nutrient analysis values to reflect improvements in the performance of food ingredient analysis equipment, revising international values to analysis values of Korean agricultural products, adjusting nutrient units, and adding newly reported nutrients related to chronic diseases. For this purpose, we integrated the different food composition databases used in each nutrition survey, updated 23 nutrients, and expanded 48 new nutrients for 3,648 food items using the latest reliable food composition databases published by national and international institutions. This revised food composition database may help to clarify the relationship between various nutrients and chronic diseases. It could serve as a valuable resource for nutritional, epidemiological, and genomic research and provide a basis for determining public health policies.

Summary

Korean summary
한국인유전체역학조사사업은 우리나라에서 가장 크고 오래된 코호트로 만성질환과 영양과의 관련성을 밝히기 위하여 사용되고 있다. 이 논문에서는 영양조사에 대한 자세한 방법론과 현재 공개하고 있는 23개 영양소의 업데이트 및 48개 새로운 영양소의 확대에 대한 내용을 소개하였다. 이러한 개선을 통해 KoGES 영양 데이터의 활용도가 더욱 높아질 것으로 기대된다.

Key Message
The Korean Genome and Epidemiology Study (KoGES) is the largest and longest-running cohort study in South Korea aimed at identifying the relationship between chronic diseases and nutrient intake. This paper provides a detailed methods of the nutritional surveys and introduces updates to the existing 23 nutrients and the addition of 48 new nutrients. These enhancements are expected to significantly increase the utility of the KoGES nutritional data.

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Serum 25-hydroxyvitamin D levels and risk of all-cause and cause-specific mortality: A 14-year prospective cohort study
Sihan Song, Jieun Lyu, Bo Mi Song, Joong-Yeon Lim, Hyun-Young Park
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Cohort Profile

Cohort profile: the Taiwan Initiative for Geriatric Epidemiological Research - a prospective cohort study on cognition: Pei-Iun Hsieh, Te-Hsuan Huang, Jeng-Min Chiou, Jen-Hau Chen, Yen-Ching Chen; Epidemiol Health. 2024;46:e2024057. Published online June 25, 2024; DOI: https://doi.org/10.4178/epih.e2024057

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Abstract Summary PDF: Abstract
The Taiwan Initiative for Geriatric Epidemiological Research (TIGER) was founded in 2011 to elucidate the interrelationships among various predictors of global and domain-specific cognitive impairment, with the aim of identifying older adults with an increased risk of dementia in the preclinical phase. TIGER, a population-based prospective cohort, recruited 605 and 629 (total of 1,234) older adults (aged 65 and above) at baseline (2011-2013 and 2019-2022) of phase I and II, respectively. Participants have undergone structured questionnaires, global and domain-specific cognitive assessments, physical exams, and biological specimen collections at baseline and biennial follow-ups to date. By 2022, TIGER I has included 4 biennial follow-ups, with the participants comprising 53.9% female and having a mean age of 73.2 years at baseline. After an 8-year follow-up, the annual attrition rate was 6.1%, reflecting a combination of 9.9% of participants who passed away and 36.2% who dropped out. TIGER has published novel and multidisciplinary research on cognitive-related outcomes in older adults, including environmental exposures (indoor and ambient air pollution), multimorbidity, sarcopenia, frailty, biomarkers (brain and retinal images, renal and inflammatory markers), and diet. TIGER’s meticulous design, multidisciplinary data, and novel findings elucidate the complex etiology of cognitive impairment and frailty, offering valuable insights into factors that can be used to predict and prevent dementia in the preclinical phase.; Summary

Key Message
1. The Taiwan Initiative for Geriatric Epidemiological Research (TIGER), established in 2001, aims to fill the knowledge gap regarding the longitudinal associations between environmental exposure, clinical factors, and performance in global and cognitive domains. 2. TIGER has made significant findings in various aspects, including the effects of exposure to low-level air pollutants, indoor air quality, clinical factors (brain and retinal images, dental health), nutrition, and biomarkers on cognition over time. 3. TIGER's multidisciplinary data and advanced analysis elucidate the predictors of cognitive impairment, identifying older adults at increased risk of dementia in the preclinical phase for early prevention and intervention.

Systematic Review

The effectiveness of protein supplementation combined with resistance exercise programs among community-dwelling older adults with sarcopenia: a systematic review and meta-analysis: Phatcharaphon Whaikid, Noppawan Piaseu; Epidemiol Health. 2024;46:e2024030. Published online February 14, 2024; DOI: https://doi.org/10.4178/epih.e2024030

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Abstract

OBJECTIVES
The combination of protein supplementation and resistance exercise shows promise for improving and maintaining muscle mass, strength, and performance in older adults with sarcopenia. This systematic review aimed to evaluate the effects of this combination on muscle mass, muscle strength, and physical performance in community-dwelling older adults with sarcopenia.

METHODS

We conducted a comprehensive search of 4 electronic databases: PubMed, Scopus, Embase, and the MEDLINE Library. The search covered literature from January 2013 to January 2023 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers assessed the methodological quality of each study using the standard critical appraisal tool from the Joanna Briggs Institute (JBI). Meta-analysis was performed with the JBI Sumari program.

RESULTS

The review included 7 randomized controlled trials and 1 quasi-experimental study, encompassing a total of 854 participants aged 60 years and above. The study durations ranged from 10 weeks to 24 weeks. An analysis of standardized mean differences (SMDs) showed that protein supplementation combined with resistance exercise significantly increased muscle mass (SMD, 0.95; 95% confidence interval [CI], 0.13 to 1.78; p<0.05) and muscle strength (SMD, 0.32; 95% CI, 0.08 to 0.56; p<0.05).

CONCLUSIONS

Although the limited number of randomized controlled trials restricts the robustness of our conclusions, the evidence suggests that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.

Summary

Key Message
Sarcopenia is a significant health concern. Given the contextual variations and the diverse factors that contribute to the prevalence of sarcopenia, delivering precision interventions to older adults diagnosed with sarcopenia who still reside in the community poses unique challenges. Therefore, precision interventions are vital for proper and feasible treatment planning, especially for early management actions, to reduce the impact of sarcopenia and its associated adverse effects in older adults. Our systematic review and meta-analysis showed that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.

Citations

Citations to this article as recorded by

The Impact of Protein in Post-Menopausal Women on Muscle Mass and Strength: A Narrative Review
Katherine Elizabeth Black, Penelope Matkin-Hussey
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Original Article

Causal effect of serum matrix metalloproteinase levels on venous thromboembolism: a Mendelian randomization study: Deheng Han, Fangcong Yu, Liangrong Zheng; Epidemiol Health. 2024;46:e2024046. Published online April 7, 2024; DOI: https://doi.org/10.4178/epih.e2024046

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Serum matrix metalloproteinase (MMP) levels are associated with cardiovascular diseases. However, the causal associations between serum levels of specific MMPs and venous thromboembolism (VTE) remain unclear. The present study sought to explore the causal relationship between serum MMP levels and VTE by using the Mendelian randomization (MR) method.
METHODS
In this study 2-sample MR study, the exposure data on serum MMP levels were derived from genome-wide association studies involving 21,758 individuals from 13 cohorts of European descent. The outcome data on VTE, including deep vein thrombosis and pulmonary embolism, were derived from the FinnGen research project. The primary method used was the inverse-variance weighting method. The MR-Egger intercept test and the Cochran Q test were used to evaluate pleiotropy and heterogeneity.
RESULTS
Using the inverse-variance weighting method, higher serum MMP-12 levels were found to be associated with an increased risk of VTE (odds ratio, 1.04; 95% confidence interval, 1.01 to 1.07; p=0.001). Moreover, there was a weak association between the levels of certain MMPs and VTE. Sensitivity analyses revealed no significant heterogeneity and pleiotropy in our study, and the Steiger directionality test did not reveal a significant reverse causation association.
CONCLUSIONS
There is a causal association between MMP-12 levels and VTE, which may have substantial implications for the diagnostic and therapeutic strategies used for VTE.; Summary

Key Message
We found that there is a causal association between matrix metalloproteinase-12 levels and venous thromboembolism. Serum matrix metalloproteinase may have profound implications on the diagnostic andtherapeutic strategies used for venous thromboembolism.

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