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Associations of depressive symptoms with lower extremity function and balance in Korean older adults
Bong Jo Kim, Kyupin Ha, Hyun Soo Kim, Hye Ran Bae, Minkook Son
Epidemiol Health. 2024;46:e2024021.   Published online January 15, 2024
DOI: https://doi.org/10.4178/epih.e2024021
  • 3,651 View
  • 85 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The relationship of depressive symptoms to lower extremity function and balance, especially in older adults without a depression diagnosis, remains unclear. Therefore, our study analyzed this relationship using a large sample of Korean older adults.
METHODS
We used data from the Korean National Health Insurance Service’s Health Screening Program database. Individuals aged 66 years who had undergone the National Screening Program for Transitional Ages in Korea and were without a diagnosis of depressive disorder were included. The lower extremity function and balance were evaluated using 2 physical tests, while depressive symptoms were assessed using a 3-question survey. Multivariable-adjusted logistic regression analysis was used to examine the association between depressive symptoms and lower extremity function and balance.
RESULTS
Among 66,041 individuals, those with depressive symptoms showed significantly higher rates of abnormal lower extremity function and abnormal balance. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association of depressive symptoms to abnormal lower extremity function and abnormal balance were (aOR, 1.34; 95% CI, 1.25 to 1.44) and (aOR, 1.38; 95% CI, 1.29 to 1.48), respectively. Assessment of the relationship based on depressive symptom scores revealed that higher scores were associated with higher aORs (p for trend <0.001). Subgroup analyses further confirmed this relationship, especially among patients with cerebrovascular disease or dementia.
CONCLUSIONS
This study revealed an association between depressive symptoms and the abnormal lower extremity function and balance of 66-year-old individuals without a diagnosis of depressive disorder.
Summary
Key Message
• This study investigated the associations of depressive symptoms with lower extremity function and balance in 66-year-old individuals without a diagnosis of major depressive disorder.
• Older adults with depressive symptoms showed significantly higher levels of abnormal lower extremity function and balance than those without.
• Higher depressive symptom scores were associated with higher odds ratios for abnormal lower extremity function and balance.
Risk of chronic periodontitis in patients with obstructive sleep apnea in Korea: a nationwide retrospective cohort study
Seon-Rye Kim, Minkook Son, Yu-Rin Kim
Epidemiol Health. 2023;45:e2023032.   Published online March 6, 2023
DOI: https://doi.org/10.4178/epih.e2023032
  • 5,966 View
  • 160 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of this study was to determine whether the development of chronic periodontitis is more likely among patients who have been newly diagnosed with obstructive sleep apnea (OSA) through an analysis of representative data from the general population.
METHODS
A nationwide, population-based, retrospective cohort study was conducted using patient records from the Korean National Health Insurance Service database. For the period 2004-2019, patient data were categorized into 2 groups: a diagnosis of OSA (747 subjects) and no diagnosis of OSA (1,494 subjects). Subsequently, 1:2 propensity score matching was performed to ensure the homogeneity of the 2 groups. To analyze the risk of incident chronic periodontitis, a Cox proportional-hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).
RESULTS
In the Kaplan-Meier curve, the disease-free probability was significantly lower in the OSA group than in the non-OSA group (p for log-rank test=0.001). The crude HR for the association between OSA and chronic periodontitis was 1.29 (95% CI, 1.16 to 1.43). The multivariable-adjusted HR was calculated at 1.28 (95% CI, 1.15 to 1.42).
CONCLUSIONS
This study confirmed a relationship between OSA and chronic periodontitis. Therefore, OSA patients require oral care to prevent the progression of chronic periodontitis from mild to severe.
Summary
Korean summary
폐쇄성수면무호흡증 환자의 만성치주염 발생위험 차이를 분석한 결과, 폐쇄성수면무호흡증 그룹에서 만성치주염의 발생위험이 높았다. 따라서 폐쇄성수면무호흡증 환자의 만성치주염 초기치료 및 질환의 진행이 되지 않도록 전문가의 효과적인 구강관리가 필요할 것이다.
Key Message
As a result of analyzing the difference in the risk of chronic periodontitis among patients with obstructive sleep apnea, the risk of chronic periodontitis was higher in the obstructive sleep apnea group. Therefore, effective oral care by experts will be necessary to prevent the initial treatment of chronic periodontitis and progression of the disease in patients with obstructive sleep apnea.

Citations

Citations to this article as recorded by  
  • Diagnosis and Management of Obstructive Sleep Apnea: Updates and Review
    Shan Luong, Liz Lezama, Safia Khan
    Journal of Otorhinolaryngology, Hearing and Balance Medicine.2024; 5(2): 16.     CrossRef
  • Oral Health Implications of Obstructive Sleep Apnea: A Literature Review
    Antonino Maniaci, Salvatore Lavalle, Riccardo Anzalone, Antonino Lo Giudice, Salvatore Cocuzza, Federica Maria Parisi, Filippo Torrisi, Giannicola Iannella, Federico Sireci, Gianluca Fadda, Mario Lentini, Edoardo Masiello, Luigi La Via
    Biomedicines.2024; 12(7): 1382.     CrossRef
  • Association between nonalcoholic fatty liver disease scores and chronic periodontitis: A retrospective cohort study
    Kwangmin Joo, Yeo Wool Kang, Sang Yi Moon, Yang Hyun Baek, Minkook Son
    Journal of Periodontology.2024;[Epub]     CrossRef
  • Sleep and periodontal health
    Maria Clotilde Carra, Pauline Balagny, Philippe Bouchard
    Periodontology 2000.2024; 96(1): 42.     CrossRef
  • Exploring the links between periodontal diseases and obstructive sleep apnoea: An overview for clinicians
    MC Carra, PA Cistulli
    Australian Dental Journal.2024;[Epub]     CrossRef
Risk of dementia according to the severity of chronic periodontitis in Korea: a nationwide retrospective cohort study
Seon-Rye Kim, Minkook Son, Yu-Rin Kim, Hyun-Kyung Kang
Epidemiol Health. 2022;44:e2022077.   Published online September 21, 2022
DOI: https://doi.org/10.4178/epih.e2022077
  • 9,670 View
  • 293 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the risk of dementia in older adults with chronic periodontitis according to the severity of periodontitis.
METHODS
Data on patients with chronic periodontitis were extracted from the National Health Insurance Service-Senior cohort database from 2002 to 2014. Among 52,728 subjects eligible for inclusion, 11,953 subjects had newly diagnosed mild chronic periodontitis (MCP), and 40,775 subjects had newly diagnosed severe chronic periodontitis (SCP). Two 1:1 propensity score matched cohorts were created with 8,624 patients each in the MCP and SCP groups. To analyze the risk of dementia, a Cox proportional-hazard model was used to calculate hazard ratios with 95% confidence intervals (CIs).
RESULTS
In the Kaplan-Meier curve, the disease-free probability was significantly lower in the SCP group than in the MCP group (p for log-rank=0.001). In the multivariable-adjusted model, the HR for the occurrence of dementia in the SCP group compared to the MCP group was 1.15 (95% CI, 1.04 to 1.27; p=0.009). A subgroup analysis revealed a significant association between dementia and the severity of periodontitis, especially in subjects who were male, aged ≥70 years, and had comorbidities.
CONCLUSIONS
Reducing the severity of chronic periodontitis can help to reduce the risk of dementia. Therefore, it is necessary to aggressively conduct early dementia-prevention programs for males under the age of 70 that include dental health to prevent the progression of periodontitis from mild to severe.
Summary
Korean summary
본 연구는 만성치주질환을 가진 노인의 만성치주질환 중등도에 따른 치매 발생위험 차이를 분석하였다. 그 결과, 만성치주질환 중등도가 높은 그룹에서 만성치주질환 중등도가 낮은 그룹에 비해 치매 발생위험이 높았으며, 특히, 남성과 70세 이상 그룹에서 유의한 차이가 있었다. 따라서 70세 이하 남성 노인을 대상으로 만성치주질환이 진행되지 않도록 효과적인 구강관리가 필요할 것이다.
Key Message
In this study, we confirmed that the severity of chronic periodontitis is related to the risk of dementia, so efforts for effective oral care will be needed.

Citations

Citations to this article as recorded by  
  • Association between statin compliance and risk of dementia among patients with chronic periodontitis
    Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
    Oral Diseases.2024; 30(5): 3440.     CrossRef
  • Impact of periodontal disease on cognitive disorders, dementia, and depression: a systematic review and meta-analysis
    Vittorio Dibello, Carlo Custodero, Raffaele Cavalcanti, Domenico Lafornara, Antonio Dibello, Madia Lozupone, Antonio Daniele, Alberto Pilotto, Francesco Panza, Vincenzo Solfrizzi
    GeroScience.2024; 46(5): 5133.     CrossRef
  • With Teeth, Broken, or Fixed: The Challenges of Linking Periodontitis, Neuroepidemiology, and Biomarkers of Disease
    James M. Noble, Panos N. Papapanou
    Journal of Alzheimer's Disease.2023; 93(3): 991.     CrossRef
  • Periodontal Pathogens and Their Links to Neuroinflammation and Neurodegeneration
    David Visentin, Ivana Gobin, Željka Maglica
    Microorganisms.2023; 11(7): 1832.     CrossRef
The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database
Seon-Rye Kim, Minkook Son, Yu-Rin Kim
Epidemiol Health. 2022;44:e2022055.   Published online July 5, 2022
DOI: https://doi.org/10.4178/epih.e2022055
  • 9,923 View
  • 331 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis.
METHODS
Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index.
RESULTS
In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities.
CONCLUSIONS
Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.
Summary
Korean summary
만성치주질환을 가진 노인에서 스타틴 복용순응도가 낮은 그룹에 비해 높은 그룹이 뇌졸증 발생위험이 낮았다. 특히 여성과 후기 노인 (85세 이상), 동반 질환을 가진 그룹에서 유의한 차이가 있었다. 따라서 스타틴 복용 순응도를 증대시키기 위한 의료진의 노력이 필요할 것이다.
Key Message
The stroke risk of chronic periodontal disease patients was related to statin medication compliance, and the effect of stroke risk was different in women, the elderly, and comorbidities.

Citations

Citations to this article as recorded by  
  • Association between statin compliance and risk of dementia among patients with chronic periodontitis
    Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
    Oral Diseases.2024; 30(5): 3440.     CrossRef
  • The association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus among the elderly population
    Mohammad-Hossein Heydari, Farshad Sharifi, Shayan Sobhaninejad, Ali Sharifi, Leili Alizadeh, Soheila Darmiani, Shima Bijari, Parvin Parvaie, Soheila Bakhshandeh, Shervan Shoaee, Mohammad-Hossein Khoshnevisan
    Journal of Diabetes & Metabolic Disorders.2024; 23(1): 1371.     CrossRef
  • Impact of statin treatment on cardiovascular events in patients with retinal vein occlusion: a nested case-control study in Korea
    Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim
    Epidemiology and Health.2023; 45: e2023035.     CrossRef

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