도시 대기오염의 위해 평가에 있어서 황사효과 분석 -서울시 총사망 및 원인별 사망률에 미치는 영향-

손지영,조용성,김윤신,이종태,김연정,Son, Ji-Young,Cho, Yong-Sung,Kim, Yoon-Shin,Lee, Jong-Tae,Kim, Yeon-Jung 한국환경보건학회 2009 한국환경보건학회지 Vol.35 No.4

The objectives of this study were to compare the relative risk of all-cause mortality and cause-specific mortality associated with Asian dust events, and especially to investigate the effects on the susceptible population such as the elderly and children, which were based on the data in Seoul from 2000 to 2006. Both of the study periods with/without Asian dust days, respiratory-cause mortality was the highest, followed by cardiovascular-cause mortality and all-cause mortality in sequence among mortality related to air pollution for all-aged group. As to susceptible group, the relative risk of mortality is the highest for +65 yrs group among all-cause mortality. According to comparison of mortality with/without Asian dust days, the relative risk of all-cause mortality is larger in the model with Asian dust days than the one in the model without Asian dust days among all age group (except for under 15 yrs group) and all air pollutants. The relative risk of cause-specific mortality (except for ozone in under 15 yrs group in case of respiratory-cause mortality, and ozone in all age group and over 65 yrs group in case of cardiovascular-cause mortality) per IQR increase of each pollutant is larger in the model without Asian dust days.

커피섭취와 수면과 관련된 사망위험도 연구

이성희,신철,조우균,조남한 대한지역사회영양학회 2015 대한지역사회영양학회지 Vol.20 No.4

Objectives: While recent studies showed that coffee consumption reduced the risk of allcause mortality, no study has examined the effect of coffee consumption on all-cause mortality related to sleep disorders. We aimed to examine whether sleep-related disorders would differently affect the association between coffee consumption and the risk of all-cause mortality among 8,075 adults aged 40 to 69 years. Methods: In a prospective cohort study, the study participants were biennially followed up for 12 years from 2001 to 2012. On each follow-up visit, the participants underwent comprehensive tests including anthropometric examinations, interviewer-administered questionnaires, and biochemical tests. Coffee consumption frequency and the amount were measured using a semi-quantitative food frequency questionnaire. Using death certificate data from Korean National Statistical Office, the vital status of each study participant was identified. Sleep-related disorders were examined with interviewer-administered questionnaires. We estimated Hazard ratios and the corresponding 95% confidence intervals from Cox Proportional Hazard models. Multivariable models were established after adjusting for center, total caloric intake, age, gender, body mass index, physical activity, education, smoking, drinking, hypertension, diabetes, total cholesterol, c-reactive protein, energyadjusted food groups of refined grains, vegetables, fruits, meat, fish, and dairy. Results: Compared with those who had no coffee consumption, participants who had about three cups of coffee per day showed a reduced risk of all-cause mortality, after adjusting for covariates. Those who had a sleep-related disorder showed no significant effect of coffee consumption on the risk of all-cause mortality, whereas those who had no sleep-related disorders showed significantly reduced risk of all-cause mortality. Conclusions: Our findings suggested that approximately three cups of coffee per day would be beneficial to reduce the risk of all-cause mortality only among adults with no sleep-related disorders. Coffee consumption should be prudent for those with sleep-related symptoms.

High serum adiponectin concentration and low body mass index are significantly associated with increased all-cause and cardiovascular mortality in an elderly cohort, ''adiponectin paradox'': The Korean Longitudinal Study on Health and Aging (KLoSHA)

Choi, S.H.,Ku, E.J.,Hong, E.S.,Lim, S.,Kim, K.W.,Moon, J.H.,Kim, K.M.,Park, Y.J.,Park, K.S.,Jang, H.C. Elsevier/North-Holland Biomedical Press 2015 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.183 No.-

Background: The relationship between adiponectin concentration and mortality is unclear. We examined whether serum adiponectin concentration is associated with all-cause and cardiovascular mortality in elderly Asians. Methods: We analyzed the data for community-dwelling adults ≥65years of age (439 men and 561 women) who were enrolled in the Korean Longitudinal Study on Health and Aging (KLoSHA) cohort in prospective manner. The baseline serum total and high molecular weight adiponectin were measured using an enzyme-linked immunosorbent assay. Using Cox regression, we determined the associations between serum adiponectin concentration and all-cause and cardiovascular mortality after adjusting for well-known cardiovascular risk factors. Results: Over a mean follow-up time of 6.2years, 222 individuals died, and 52 deaths (23.4%) were by cardiovascular disease. After adjusting confounding factors, elevated baseline serum adiponectin concentration was independently associated with all-cause mortality (adjusted hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.17-1.64) and cardiovascular mortality (HR 1.50; 1.06-2.14). We evaluated the effect modification by baseline body mass index (BMI). High serum adiponectin and low BMI were synergistically associated with increased all-cause mortality (HR 6.25; 3.08-12.71) and cardiovascular mortality (HR 13.94; 1.82-106.58). Conclusions: Higher serum adiponectin concentration was associated with increased all-cause and cardiovascular mortality in community-dwelling elderly Asian population. Our data supported the recent theory so called ''adiponectin paradox''. This relationship was strengthened when combined with low BMI. We suggest that measurement of adiponectin concentration and BMI together could be an additional predictive marker of survival among elderly adults.

Association of Grip Strength with All-Cause Mortality among Korean Adults with Disabilities

임상훈 한국운동생리학회 2023 운동과학 Vol.32 No.4

PURPOSE: This study utilized data from the Korean Longitudinal Study of Aging to investigate the association between grip strength and all-cause mortality rates in adults with disabilities aged ≥45 years in Korea. METHODS: The study included 430 adults with disabilities without missing values in the mortality variable and no history of cancer, cerebrovascular diseases, or cardiovascular diseases (mean age 63.2±10.0 years) for analysis. Data from the first to seventh waves were used in the analysis. Grip strength was measured using a dynamometer, and mortality status and date were recorded. A Cox proportional hazards model was used to examine the association between grip strength and all-cause mortality rates to calculate the adjusted hazard ratios (HRs) and their corresponding 95% confidence intervals (95%CIs), considering potential confounding variables. Finally, a joint association between grip strength, obesity, and all-cause mortality was assessed. RESULTS: During a median follow-up of 9.09±3.73 years, 135 adults with disabilities died. After adjusting all possible confounding variables, the HR of the group with the highest grip strength was significantly lower (HR: .36; 95% CI: .20-.65) than that of the group with the lowest grip strength. In the joint analysis, compared to the “weak and non-obese” group, the HRs (95% CIs) of all-cause mortality were .32 (.17-.62) and .27 (.10-.71) in the “strong and non-obese” and “strong and obese” groups, respectively. CONCLUSION: High grip strength in Korean adults with disabilities aged ≥45 years was significantly associated with a lower all-cause mortality risk, independent of obesity. Hence, grip strength may be a simple indicator of mortality risk; however, additional research using large-scale survey data is required.

중·고령자의 악력저하와 동반질환이 모든 원인으로 인한 사망 위험에 미치는 영향

이인환 ( Inhwan Lee ),강현식 ( Hyunsik Kang ) 한국운동생리학회(구 한국운동과학회) 2020 운동과학 Vol.29 No.1

PURPOSE: This study investigated the combined impact of low hand grip strength (HGS) and number of comorbidities on the risk of all-cause mortality in Korean middle-aged and older adults. METHODS: Data from the 2006 baseline and 2016 follow-up assessments of the Korean longitudinal study of aging (KLoSA) involving 9,270 Korean adults aged ≥45 years (55.6% women) were used in the study. Study participants were classified as zero, one, and two or more categories based on number of co-morbidities and as high, middle, and low categories based on HGS distributions. The Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of all-cause mortality according to HGS categories and number of comorbidities. RESULTS: During the 9.7±2.7 year follow-up period, 1,285 deaths from all causes occurred. In both middle and low HGS categories, one and two or more comorbidities resulted in an increased risk of all-cause mortality (HR=1.493; 95% CI=1.220-1.828; p<.001 and HR=1.427; 95% CI=1.190-1.711; p<.001, respectively) compared to no comorbidity (HR=1). Furthermore, the increased risks of all-cause mortality remained significant even after adjustments for a number of confounders such as age, sex, socio-economic status, and parameters of health behaviors and conditions. In high HGS category, there were no significant differences in the risk of all-cause mortality according to number of co-morbidities. CONCLUSIONS: The current finding suggested that promotion of upper body muscular strength may play an important role in preventing premature death from all causes, especially among those who suffer from co-morbidities.

서울시 중년남성에서 육체적 활동량이 총 사망률에 미치는 영향에 관한 코호트 연구

김대성,구혜원,김동현,배종면,신명희,이무송,이충민,안윤옥,Kim, Dae-Sung,Koo, Hye-Won,Kim, Dong-Hyon,Bae, Jong-Myon,Shin, Myung-Hee,Lee, Moo-Song,Lee, Chung-Min,Ahn, Yoon-Ok 대한예방의학회 1998 예방의학회지 Vol.31 No.4

Although previous studies revealed the association of physical activity with mortality rate, it is unclear whether there is a linear trend between physical activity and mortality rate. In this study, the association of physical activity with the risk of all-cause mortality was analysed using Cox's proportional hazard model for a cohort of 14,204 healthy Korean men aged 40-59 years followed up for 4 years(Jan. 1993-Dec. 1996). Physical activity and other life style were surveyed by a postal questionnaire in December 1992. Total of 14,204 subjects were grouped into quartiles by physical activity. Using death certificate data, 123 deaths were identified. The second most active quartile had a lowest mortality .ate with relative risk of 0.44(95% C.I. : 0.23-0.84) compared with most sedentary quartile, showing a J-shape pattern of physical activity-mortality curve. By examining the difference in proportion of cause of the death between most active quartile and the other quartiles, there was no significant difference of proportional mortality from cardiovascular deaths, cerebrovascular deaths or deaths from trauma. The covariates were stratified into two group between which the trend of RR was compared to test the effect modification. There was no remarkable effect modification by alcohol intake, smoking, body mass index, calorie consumption, percent fat consumption. In conclusion, moderate activity was found to have more protective effect on all-cause mortality than vigorous activity and that the J-shape pattern of physical activity-mortality curve was not due to the difference of mortality pattern or effect modification by alcohol intake, smoking, body mass index, calorie consumption and percent fat consumption.

Depressive Symptoms and Mortality Among Middle-Aged and Older Adults in South Korea

Yun Hyeon-Seung,Kim Jae-Hyun,Bae Sung-Man 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.4

Objective This study’s aim is to verify the longitudinal effect of depressive symptoms on all-cause mortality depending on the age group.Methods The Korean Longitudinal Study of Aging’s data from 2006 to 2016 were assessed using longitudinal data analysis, and 10,145 participants (age [mean±standard deviation], 61.7±11.1 years; males, 4,426 [43.6%]; females, 5,719 [56.4%]; middle-aged adults, 6,036 [59.5%]; older adults, 4,109 [40.5%]) were included at baseline. The chi-square test, log-rank test, factor analysis, and Cox proportional hazards models were used to investigate the association between depressive symptoms and mortality. To verify that which feelings and behaviors are associated with mortality, factor analysis was used to Center for Epidemiologic Studies Depression (CES-D) scale and it was divided into two factors: negative and positive affects.Results The hazard ratio (HR) of all-cause mortality for the Q1 (high) of the negative affect factor was higher than the Q3 (low) of this factor (HR, 1.489; 95% confidence interval, 1.284–1.728). Additionally, the association between negative affect and all-cause mortality was stronger in middle-aged adults than older adults.Conclusion The study provided evidence of the longitudinal effect of depressive symptoms on all-cause mortality regardless of age. However, middle-aged adults could be more sensitive to negative feelings and behaviors than older adults.

지체장애 노인의 저강도 신체활동과 모든 원인 사망과의 연관성

이인환,강현식 한국운동생리학회 2022 운동과학 Vol.31 No.3

PURPOSE: This study aimed to investigate the association between light intensity physical activity (LPA) and all-cause mortality in older adults with physical disability. METHODS: Data from the 2008 Living Profiles of Older People Survey involving 14367 Korean adults aged ≥60 y (13417 without disabilities and 950 with disabilities) were used. Participants were divided into active and inactive groups based on weekly LPA and moderate-to-vigorous intensity physical activity (MVPA). Cox proportional hazards regression model was used to calculate hazard ratio (HR) and 95% confidence interval (CI), according to disability status and physical activity levels. RESULTS: During 3.3±0.4 years follow-up period, 1024 deaths occurred from all causes. Among non-disabled people, the inactive group showed a significantly higher risk of all-cause mortality (HR=1.282, 95% CI=1.122–1.465, p<0.001) than the active group (reference=1) in LPA. Similarly, for MVPA, the risk of all-cause mortality was significantly higher in the inactive group (HR=1.522, 95% CI=1.230–1.882, p<0.001) than in the active group (reference=1). However, among physically disabled people, the inactive group correspondingly showed a significantly higher risk of all-cause mortality (HR=2.735, 95% CI=1.761–4.246, p<0.001) than the active group, while there was no significant difference between both groups in MVPA. CONCLUSIONS: The current findings suggest that promoting LPA may play an important role in preventing premature death from allcause mortality in older adults with physical disability.

Age-Related Difference in Weight Change and All-Cause Mortality in Middle-Aged and Older Korean Populations: Korean Longitudinal Study of Aging

Jungki Suh,Yoon Jeong Cho,Hyun Ji Kim,Seong Soo Choi 대한가정의학회 2021 Korean Journal of Family Medicine Vol.42 No.4

Background: Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain. Methods: We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk. Results: The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10–2.40) for the participants aged 45–65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29–1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results. Conclusion: This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.

Colonoscopic Screening and Risk of All-Cause and Colorectal Cancer Mortality in Young and Older Individuals

이정아,장유수,김예진,박동일,박수경,박혜인,고재우,이수진,류승호 대한암학회 2023 Cancer Research and Treatment Vol.55 No.2

Purpose The incidence of early-onset colorectal cancer (CRC) and associated mortality have been increasing. However, the potential benefits of CRC screening are largely unknown in young individuals. We aimed to evaluate the effect of CRC screening with colonoscopy on all-cause and CRC mortality among young (aged < 45 years) and older (aged ≥ 45 years) individuals. Materials and Methods This cohort study included 528,046 Korean adults free of cancer at baseline who underwent a comprehensive health examination. The colonoscopic screening group was defined as those who reported undergoing colonoscopy for CRC screening. Mortality follow-up until December 31, 2019 was ascertained based on nationwide death certificate data from the Korea National Statistical Office. Results Colonoscopic screening was associated with a lower risk of all-cause mortality in both young and older individuals. Multivariable-adjusted time-dependent hazard ratios (95% confidence intervals) for all-cause mortality comparing ever- to never-screening were 0.86 (0.75-0.99) for young individuals and 0.71 (0.65-0.78) for older individuals. Colonoscopic screenings were also associated with a reduced risk of CRC mortality without significant interaction by age, although this association was significant only among participants aged ≥ 45 years, with corresponding time-dependent hazard ratios of 0.47 (0.15-1.44) for young individuals and 0.52 (0.31-0.87) for those aged ≥ 45 years. Conclusion Colonoscopic CRC screening decreased all-cause mortality among both young and older individuals, while significantly decreased CRC mortality was observed only in those aged ≥ 45 years. Screening initiation at an earlier age warrants more rigorous confirmatory studies.