Associations of regional-level perceived stress and depression with health-related quality of life in Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data

Gender-specific secular trends and related factors of high perceived stress level among Korean older adults: a nation-wide serial cross-sectional study

BACKGROUND

Aging is associated with various physical, functional, and social losses, leading to stress, which affects mental health and overall quality of life. Despite its significance, limited research exists on perceived stress and its related factors among community-dwelling older adults. This study aimed to identify temporal trends in the prevalence of high perceived stress according to sex and examine associated factors among older adults.

METHODS

This descriptive study analyzed secondary data from the nationally representative Korean Community Health Survey (KCHS) data from 2009 to 2019, including 274,883 older adults aged ≥ 65 years. High-perceived stress was coded as binary data, categorized as 'yes' or 'no' based on daily stress levels. Gender-stratified analyses examined temporal trends and associated factors affecting high perceived stress.

RESULTS

Women consistently reported higher levels of perceived stress compared with men across all years, with prevalence ranging from 22 to 30% in women and 14-20% in men. Among men, factors such as insufficient physical activity (OR: 1.32, 95% CI: 1.27-1.37), poor subjective health status (OR: 2.80, 95% CI: 2.69-2.92), and living alone were associated with high perceived stress. Among women, low household income (OR: 1.68, 95% CI: 1.56-1.81), smoking (OR: 1.63, 95% CI: 1.49-1.79), and living with a spouse (OR: 1.51, 95% CI: 1.34-1.70) were significant predictors.

CONCLUSIONS

This study highlights significant gender disparities in perceived stress among older adults, with women demonstrating greater vulnerability. Public health policies should prioritize stress reduction strategies tailored to address gender-specific needs and socio-economic disparities in older adults.

Association Between Regional Levels of Particulate Matter and Recurrent Falls in Korea

BACKGROUND

We investigated the extent of regional disparity of recurrent falls. In addition, we examined the association between particulate matter (PM) and recurrent falls and the association between regional disparity of recurrent falls and regional PM levels.

METHOD

We used data from Korea Community Health Survey 2019 that included 204,395 participants from 237 municipal districts. The independent variables were the annual average PM10 and PM2.5 concentrations measured at the air quality measuring stations in each municipal district. The outcome variable was the experience of falls more than twice in the previous year. Multilevel analyses were conducted to estimate the association between regional PM10 and PM2.5 levels and recurrent falls.

RESULTS

The regional variation was greater in the young people than that in the older people. PM10 and PM2.5 levels were positively associated with recurrent falls after adjusting for individual and regional covariates. These associations were more evident in the older group than in the young. PM10 and PM2.5 explained 2.82% and 3.33% of the remaining regional variance in models with individual and regional confounders, respectively. These proportions were greater in the older group (PM10 and PM2.5; 4.73% and 5.27%) than those in the younger age group (PM10 and PM2.5, 0.80% and 1.39%).

CONCLUSION

PM concentration was associated with recurrent falls even after accounting for other regional variables and individual-level differences. Moreover, there were regional differences in the occurrence of falls, and the PM concentration explained a part of the gap, but the gap was explained more in the older group than in the young.

Depression before and during-COVID-19 by Gender in the Korean Population

This study explored the association between Coronavirus disease (COVID-19) and depression by comparing Patient Health Questionnaire-9 (PHQ-9) results pre-pandemic (2019) and after the start of the pandemic (2020). Data of 444,051 participants (200,206 male (45.1%); 243,845 female (54.9%)) were obtained from the Korean Community Health Survey conducted from 2019 to 2020. The independent variable of interest in this study was the year, divided into binary categories, 2019 and 2020. The dependent variable was depression, measured by the PHQ-9 scale. This dependent variable was also binary, dividing those who are considered depressed or not by a cut-off score of 10. A logistic regression model was employed to examine the association. Our results reveal that compared to participants in 2019, patients from the study sample of 2020 were marginally more likely to be depressed, especially female patients (male OR: 1.092, 95% CI [0.998 to 1.195], female OR: 1.066, 95% CI [1.002 to 1.134]). Moreover, using the participants from the year 2019 as a reference group, those who appeared anxious in response to the COVID-19-related questions in the survey showed more tendency to have a PHQ-9 score of 10 or more. Compared to participants from the 2019 group, those from 2020 more likely to be depressed were those with no-one to contact in case of emergency due to COVID-19 (male OR: 1.45, 95% CI [1.26 to 1.66], female OR: 1.46, 95% CI [1.33 to 1.60]), and individuals with concerns regarding economic loss (male OR: 1.18, 95% CI [1.07 to 1.30], female OR: 1.11, 95% CI [1.04 to 1.18]) and infection of a vulnerable family member at home due to COVID-19 (male OR: 1.16, 95% CI [1.05 to 1.28], female OR: 1.09, 95% CI [ 1.02 to 1.16]).