The effects of mental health on recurrent falls among elderly adults, based on Korean Community Health Survey data.

OBJECTIVES: This study aimed to identify the effect of mental health on frequency of falls (single and recurrent falls) among elderly adults. METHODS: Data were drawn from the 2015 Korean Community Health Survey. A chi-square test was conducted to compare differences in fall frequency according to health-related behaviors, chronic diseases, and mental health. Subsequently, multinomial logistic regression analysis was used to identify the effects of mental health on single and recurrent falls based on variables found to be significant in the chi-square test. RESULTS: Recurrent falls were found to be more risky than single falls. Depression was significantly related to single falls (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.12 to 1.44). Depression (OR, 1.56; 95% CI, 1.38 to 1.76), sleep disorder (5 hours or less: OR, 1.12; 95% CI, 1.02 to 1.23; more than 9 hours: OR, 1.24; 95% CI, 1.07 to 1.44, respectively), and subjective stress (OR, 2.30; 95% CI, 1.90 to 2.78) were significantly related to recurrent falls. CONCLUSIONS: The study's findings suggest that specialized fall prevention programs are needed to address different types of falls in elderly adults. To prevent recurrent falls, systematic treatment strategies and rehabilitation training must improve physical function and mental health.

Long-term changes in the heat-mortality relationship according to heterogeneous regional climate: a time-series study in South Korea.

OBJECTIVES: Several studies identified a heterogeneous impact of heat on mortality in hot and cool regions during a fixed period, whereas less evidence is available for changes in risk over time due to climate change in these regions. We compared changes in risk during periods without (1996-2000) and with (2008-2012) heatwave warning forecasts in regions of South Korea with different climates. METHODS: Study areas were categorised into 3 clusters based on the spatial clustering of cooling degree days in the period 1993-2012: hottest cluster (cluster H), moderate cluster (cluster M) and cool cluster (cluster C). The risk was estimated according to increases in the daily all-cause, cardiovascular and respiratory mortality per 1°C change in daily temperature above the threshold, using a generalised additive model. RESULTS: The risk of all types of mortality increased in cluster H in 2008-2012, compared with 1996-2000, whereas the risks in all-combined regions and cooler clusters decreased. Temporal increases in mortality risk were larger for some vulnerable subgroups, including younger adults (<75 years), those with a lower education and blue-collar workers, in cluster H as well as all-combined regions. Different patterns of risk change among clusters might be attributable to large increases in heatwave frequency or duration during study periods and the degree of urbanisation in cluster H. CONCLUSIONS: People living in hotter regions or with a lower socioeconomic status are at higher risk following an increasing trend of heat-related mortality risks. Continuous efforts are needed to understand factors which affect changes in heat-related mortality risks.

Short-term effect of temperature on daily emergency visits for acute myocardial infarction with threshold temperatures.

BACKGROUND: The relationship between temperature and myocardial infarction has not been fully explained. In this study, we identified the threshold temperature and examined the relationship between temperature and emergency admissions due to MI in Korea. METHODS: Poisson generalized additive model analyses were used to assess the short-term effects of temperature (mean, maximum, minimum, diurnal) on MI emergency visits, after controlling for meteorological variable and air pollution (PM10, NO2). We defined the threshold temperature when the inflection point showed a statistically significant difference in the regression coefficients of the generalized additive models (GAMs) analysis. The analysis was performed on the following subgroups: geographical region, gender, age (<75 years or ≥ 75 years), and MI status (STEMI or non-STEMI). RESULTS: The threshold temperatures during heat exposure were for the maximum temperature as 25.5-31.5°C and for the mean temperature as 27.5-28.5°C. The threshold temperatures during cold exposure were for the minimum temperature as -2.5-1.5°C. Relative risks (RRs) of emergency visits above hot temperature thresholds ranged from 1.02 to 1.30 and those below cold temperature thresholds ranged from 1.01 to 1.05. We also observed increased RRs ranged from 1.02 to 1.65 of emergency visits when temperatures changes on a single day or on successive days. CONCLUSIONS: We found a relationship between temperature and MI occurrence during both heat and cold exposure at the threshold temperature. Diurnal temperature or temperature change on successive days also increased MI risk.