The Prognostic Impact of Coronary Artery Disease and Aortic Aneurysm:Insights From CT Protocol for Simultaneous Evaluation of Coronary Artery and Aorta

Background@#There is a strong correlation between risk factors for coronary artery disease (CAD) and aortic aneurysm (AA). We aimed to investigate the prevalence and prognostic impact of CAD and AA in patients who underwent coronary aorta computed tomography (CACT) protocol, which allowed simultaneous evaluation of coronary artery and aorta. @*Methods@#Between 2010 and 2021, 1,553 patients who underwent CACT were enrolled from a tertiary center. The presence and location of AA and the presence of CAD were identified from CT. The primary outcome was a composite of cardiovascular death, acute coronary syndrome requiring urgent revascularization, and stroke at 3 years after the index CT scan. @*Results@#Out of 1,553 enrolled patients, 179 (11.5%) had AA. The prevalence of CAD was significantly higher in patients with AA than those without (47.5% vs. 18.3%, P < 0.001). Among patients with AA, the prevalence of comorbid CAD was higher in those with abdominal AA than thoracic AA (57.3% vs. 37.8%, P = 0.014), respectively. In multivariable analysis, the presence of CAD was an independent predictor of primary outcome at 3 years (hazard ratio [HR], 2.58; 95% CI, 1.47–4.51; P = 0.001), while AA was not (HR, 1.00; 95% CI, 0.48–2.07; P = 0.993). @*Conclusion@#In this cohort of patients undergoing simultaneous evaluation of coronary artery and aorta using CACT protocol, patients with AA had an increased risk of comorbid CAD compared to those without AA. CAD was independently associated with adverse clinical outcomes at 3 years.

Subjective Age and Cognitive Functioning in Old Age

OBJECTIVE: The present study has examined whether subjective age would be associated with cognitive functioning in older adults. METHODS: Data from the third wave of Korean Social Life, Health, and Aging Project were used. This study was conducted with 152 older adults aged 60–89 years (mean=72.26, standard deviation=6.41) who completed measures of subjective age, Mini-Mental State Examination for Dementia Screening, Elderly Verbal Learning Test, Digit Span Test, Korean-Color Word Stroop Test, Trail Making Test, Verbal Fluency Test, Korean Boston Naming Test-Short form. The association of subjective age and cognitive functioning was analyzed using hierarchical regression analysis. Sex, depression, and chronological age were included as control variables. RESULTS: Hierarchical regression analysis revealed that a younger subjective age was associated with better processing speed, immediate memory, and executive function respectively. Even after controlling for chronological age, depression, and sex, the subjective age was associated with cognitive functioning in old age. CONCLUSION: Beyond chronological age, the subjective experience of age was associated with cognitive aging.

The Effects of Spouse Support and Conflict on Depression in Older Adults and Their Gender Difference

OBJECTIVE: The purpose of this study is to investigate the effects of spouse support and conflict on the depression in older adults, and also to explore whether there are any differences between men and women in these effects. METHODS: The participants of this study were normal and married older adults who participated in the first wave of Korean Social Life, Health, and Aging Project. Participants consisted of 221 men and 210 women. The effects of support and conflict in spousal and other relationships on depression were analyzed using hierarchical regression analysis, separately in men and women. RESULTS: In the men group, the spouse conflict was especially influential in depression. More spouse conflict resulted in greater depression among men. In the women group, however, support from individuals other than spouse (kin support and friends support) had significant effects on depression. Less support received from individuals other than spouse was associated with higher levels of depression among women. CONCLUSION: The results of this study suggest that the quality of spousal and other relationships is related to depression in older adults. Moreover, there is a gender difference in the effect of support and conflict experienced in the relationship.

Social Network, Social Support, Social Conflict and Mini-Mental State Examination Scores of Rural Older Adults : Differential Associations across Relationship Types

OBJECTIVE: This study aimed to examine the effects of the social engagement (size of the social networks, social support, social conflict) by relationship types (spouse, family and kin, and neighbor and friends) on the cognitive functions of older adults in rural communities. METHODS: The participants of this study were normal older adults who participated in the first wave of the Korean Social Life, Health and Aging Project. Five hundred two older adults (men 218, women 284) aged 60 and over (mean age=71.44±6.81) participated. We analyzed the effects of different types of social engagement on Mini-Mental State Examination for Dementia Screening (MMSE-DS) performance using hierarchical multiple regression analysis. RESULTS: The result showed that, after controlling for the education level and age, the social support from the spouse, the conflict with neighbors or friends, the number of neighbors or friends significantly predicted MMSE-DS scores. These three variables accounted for additional 5.2% of the total variance of MMSE-DS. CONCLUSION: Our findings suggest that social engagement (network size, support, conflict) is associated with cognitive function among older adults. However, social engagement in different types of social relationship may contribute differently to cognitive function of older adults.