Factors affecting depression and health-related quality of life in the elderly during the COVID-19 pandemic.

BACKGROUND: This study investigated changes in the health behaviors of the elderly due to coronavirus disease 2019 (COVID-19), concerns due to COVID-19, depression, and healthrelated quality of life (HRQOL), and aimed to identify factors that affect depression and HRQOL in the elderly. METHODS: This study was conducted using data from the 2021 Community Health Survey of the Korea Disease Control and Prevention Agency. From a total sample size of 229,242 individuals, 74,376 elderly people aged 65 or older were selected as subjects, and changes in health behaviors, concerns due to COVID-19, depression, and HRQOL were measured and analyzed. RESULTS: The level of depression associated with sleep and fatigue was high. The lowest HRQOL was related to physical pain and discomfort, while the most common concerns were related to economic difficulties. Factors influencing depression included worries about infection and economic harm, while factors impacting HRQOL encompassed concerns about infection, economic harm, and criticism from others. CONCLUSION: If an infectious disease situation such as COVID-19 reoccurs in the future, it will be necessary to encourage participation in hybrid online and offline programs at senior welfare centers. This should also extend to community counseling institutions like mental health welfare centers. Additionally, establishing connections with stable senior job projects can help to mitigate the effects of social interaction restrictions, physical and psychological health issues, and economic difficulties experienced by the elderly.

Effects of Balance Training Using a Virtual Reality Program in Hemiplegic Patients.

Therapeutic goals for hemiplegic patients with neurological impairments are mainly focused on improving their independent lives. Based on the previously reported effectiveness of Wii Fit balance training, this study investigated the most influential outcomes after long-term intensive training (including balance and functional factors) on quality of life in hemiplegic patients. The intervention group (n = 21) received Nintendo Wii Fit balance training under supervision, and control group (n = 20) received conventional balance training by an occupational therapist. Two groups were matched based on age and onset duration. Both groups received a total of 15 treatments for 30 min per session, twice a week for 8 weeks. There were significant improvements not only in balance confidence and activities of daily living, but also in body composition, such as fat proportion and metabolic rate, in the intervention group compared to the control group (p < 0.05). In particular, balance confidence significantly affected EuroQoL Visual Analogue Scale according to stepwise multiple regression analyses in this study. These results demonstrated that Wii Fit balance training using virtual reality improved the quality of life of hemiplegic patients while overcoming the asymmetrical weight distribution of the affected side via the self-modulating biofeedback exercises.

Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients.

OBJECTIVE: The aim of this study was to investigate the effect of daily living dual-task training focused on improving attention and executive function of the upper extremities, cognitive function, and quality of life in stroke patients. METHODS: We included 30 stroke patients who were hospitalized between July 2020 and October 2020. They were divided into experimental and control groups through randomization. The experimental group performed 20 minutes of dual-task training and received 10 minutes of conventional occupational therapy, while the control group performed 20 minutes of single-task training and received 10 minutes of conventional occupational therapy. Both groups underwent their respective rehabilitation for 30 minutes per session, 5 times per week for 5 weeks. RESULTS: Both groups showed significant improvements in upper extremity function, cognitive function, and quality of life; the experimental group showed higher results for all items. A significant between-group difference was observed in the magnitude of the changes. CONCLUSION: In stroke patients, dual-task training that combined attention and executive function with daily living activities was found to be meaningful, as it encouraged active participation and motivation. This study is expected to be used as a foundation for future interventions for stroke patients.

Impact of Mixed Cognitive Intervention Training on Early Onset Dementia.

OBJECTIVES: The aim of this study was to investigate the impact of mixed cognitive intervention training using spaced retrieval training, and errorless learning in participants with early onset dementia. This was based on reality orientation therapy for cognitive function, depression, and occupational performance of patients. METHODS: Two early onset vascular dementia patients (> 65 years) with mild or moderate impairment were enrolled in a pre-test - post-test single-subject research design study. Prior to the study, the caregivers were interviewed about meaningful times, people, places, and areas of interest for the participant. A list of individual training words were selected based upon this information, and the participant was instructed to recall them after a 45-second, 90-second, 6-minute, and 12-minute delay. Baseline (3 sessions), intervention (20 sessions), and a second baseline period (3 sessions) were conducted. Activities of daily living were measured, and cognition was measured using the Consortium to Establish a Registry of Alzheimer's Disease Korean version, whilst depression was measured using the Korean Form Geriatric Depression Scale, and task performance and satisfaction measured by the Canadian Occupational Performance Measure. RESULTS: After intervention, both participants showed improvements in activities of daily living (ADL), word list memory/recognition, trail making A, occupational performance, and satisfaction improvement, which was clinically significant in 1 participant who also had a reduced score in the scale of depression classifying him as not depressed. CONCLUSION: Spaced retrieval training and errorless learning based on reality orientation therapy is an effective intervention in patients with early onset dementia and mild or moderate impairment.

The Effect of a Complex Intervention Program for Unilateral Neglect in Patients with Acute-Phase Stroke: A Randomized Controlled Trial.

OBJECTIVES: The purpose of this study was to examine the combined effects of Prism Adaptation (PA) plus functional electrical stimulation (FES) on stroke patients with unilateral neglect, and suggest a new intervention method for acute-phase stroke patients. METHODS: There were 30 patients included in this study from April to October 2016 that had unilateral neglect whilst hospitalized following a stroke (diagnosed by a professional). The participants, who were patients receiving occupational therapy, understood the purpose of the study and agreed to participate. The patients were randomly divided into 3 groups: PA plus FES group (Group A), PA group (Group B), and FES group (Group C). Treatments lasted for 50 minutes per day, 5 times per week, for 3 weeks in total. Reevaluation was conducted after 3 weeks of intervention. RESULTS: All 3 groups showed unilateral neglect reduction after the intervention, but PA plus FES (complex intervention method) was more effective than PA or FES alone [effect size: Motor-free Visual Perception Test (0.80), Albert test (0.98), CBS (0.92)]. CONCLUSION: The results of this study support further studies to examine complex intervention for the treatment of unilateral neglect.

The Effects of Restricted Physical Activity on Health-Related Quality of Life in Adult Patients with Depression.

OBJECTIVES: The objective was to identify restricted physical activity in patients with depression, and to determine the effects of that restricted activity, on their health-related quality of life (HRQOL). METHODS: Data was analysed from Year 1 of the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII-1). From a total sample of 8,150 subjects, 277 adults aged ≥19 years who were diagnosed with depression were selected. The results were derived using restricted activity and HRQOL data measured from the subjects. RESULTS: Most of the participants were females ≥ 50 years old. HRQOL scores were high in the "self-care" dimension and low in the "pain/discomfort" and "anxiety/depression" dimensions. Their restricted activity due to illness in the past year, led to increases in participants being bedridden or absent from work. Many participants reported being bedridden for more than 3 months. A higher number of absences owing to illness in the past year, and longer durations of being bedridden, had a negative impact on HRQOL. Age, marital status, educational level, income level, and occupation were the sociodemographic variables that had an impact on HRQOL. CONCLUSION: Patients with depression experiencing stress in their daily lives should take measures to avoid illness and pain that may lead to them becoming bedridden, and employ lifestyle habits with support from families and community health promotion centres, where mental health counselling can be accessed.

A Study on the Physical Activities, Mental Health, and Health-Related Quality of Life of Osteoarthritis Patients.

OBJECTIVES: The purpose of this study was to investigate the physical activities, mental health, and health-related quality of life (HRQOL) of osteoarthritis patients. METHODS: This study was conducted using data from the first year of the 7th Korea National Health and Nutritional Examination Survey. There were 8,150 participants included in the survey, and 665 participants had been diagnosed with osteoarthritis. This study analyzed the measurements of physical activities, depression, and HRQOL in participants with osteoarthritis. RESULTS: The mean age of the participants was 67 ± 9.9 years and 83.1% were female. Participants rarely engaged in work-related physical activity, and engaged in leisure-related physical activities infrequently. Most of the participants (85.9%) did not do regular exercise, but 1/3 of the participants walked for over 10 minutes a day. "Pain/discomfort" had the least impact upon HRQOL, and among the depression subcategories, "difficult to sleep and tiredness" had the most impact. Multiple logistic regression analysis showed that an adverse HRQOL score was statistically significantly associated with "location changes/physical activities" (p < 0. 01), "depression" (p < 0.001) and "age" (p < 0.001). CONCLUSION: Exercise programs should be in place which are manageable in everyday life for the elderly (> 65 years). Changes in daily routine so that patients become more active, should be supported by the family and community, together with assistance in managing psychological problems such as depression.

Effects of Physical Activity on Depression in Adults with Diabetes.

OBJECTIVES: The purpose of this study was to identify the current state of physical activity in adults with diabetes and to investigate the effect of physical activity on depression. METHODS: The present study was conducted using data from the 2nd year of the 6th Korea National Health and Nutritional Examination Survey. From the total of 7,550 individuals, 418 adults diagnosed with diabetes were selected as participants, and their physical activity and depression levels were examined. RESULTS: The physical activity status of the participants showed that they did not usually engage in physical activities at work, and only a few participants were involved in moderate intensity physical leisure activity. Apart from walking for 10 minutes each day, which accounted for 1/3 of the participants, most of the participants did not engage in specific forms of exercise. An examination of the effects of physical activity on depression revealed that moderate intensity physical activity at work and leisure influenced depression. In terms of demographic characteristics, gender, occupation, income quintile, and subjective health status were all found to affect depression. CONCLUSION: For elderly (60 years or older) patients with diabetes, which accounted for the majority of the diabetic population, a systematic leisure program and professional education are necessary to help them to manage stress and depression in daily life. Additionally, provision of community and family support should encourage regular, moderate intensity exercise and promote lifestyle changes to encourage increased physical activity.

Study on Cardiopulmonary Function, Maximal Oxygen Uptake, and Obesity Index according to Smoking Status in Middle-Aged and Older Office Workers.

OBJECTIVES: To investigate the effect of smoking upon cardiopulmonary function, maximal oxygen uptake, and obesity index, in middle-aged and older workers to propose guidelines on healthcare for these age groups. METHODS: This study analyzed medical data from 2,753 white-collar workers aged 50 years or older from workplaces located in Seoul, South Korea. Blood pressure (BP), resting heart rate, maximal oxygen uptake (VO2max), and body mass index (BMI) of each subject were measured. The collected data were analyzed using SPSS 21.0. RESULTS: In the smoking group BP and resting heart rate were significantly higher than in the non-smoking and smoking-cessation groups (p < 0.05). In addition, VO2max was lower in the smoking group compared to the other 2 groups. BP closely correlated with resting heart rate, abdominal fat ratio, and BMI. BMI was the highest in the group that stopped smoking and, BMI and abdominal fat ratio negatively correlated with VO2max. CONCLUSION: Smoking increases the risk of cardiopulmonary disease but obesity may be caused by stopping smoking. Therefore, healthcare guidelines on smoking cessation should also include nutritional advice.

Effects of Oral Stimulation Intervention in Newborn Babies with Cri du Chat Syndrome: Single-Subject Research Design.

The purpose of this study is to treat dysphagia in a newborn baby with cri du chat syndrome using an oral stimulation intervention and to examine its effects. The subject of this study was a baby born 2 weeks prematurely. Since birth, his oxygen saturation (SaO2) decreased while feeding, and he had difficulty with mouth feeding. Thus, an NG feeding tube was inserted, and dysphagia treatment was initiated on the sixth day after birth. A baseline phase and an intervention phase were performed using an AB design. The oral stimulation intervention was not performed in the baseline phase, as only nonnutritive sucking training using a rubber pacifier was used during the baseline phase. During the intervention phase, nonnutritive sucking training and oral stimulation intervention were simultaneously conducted. After the intervention period, daily oral milk intake and intake per feeding of the subject noticeably increased. The oxygen saturation while feeding rose over 90% on average, and the baby did not present with hypoxia. The oral stimulation intervention provided prior to feeding resulted in highly positive effects, including induced normal development of the baby, stimulation of his transition from the NG feeding tube to bottle feeding, increased oxygen saturation, and a shortened hospital stay.