농촌지역 노인들의 인지기능 장애와 사망과의 관련성

선병환,박경수,나백주,박요섭,남해성,신준호,손석준,이정애,Sun, Byeong-Hwan,Park, Kyeong-Soo,Na, Baeg-Ju,Park, Yo-Seop,Nam, Hae-Sung,Shin, Jun-Ho,Sohn, Seok-Joon,Rhee, Jung-Ae 대한예방의학회 1997 예방의학회지 Vol.30 No.3

60세이상 노인인구를 대상으로 '농촌지역 노인들의 우울 및 인지기능 장애에 관한 연구'를 한 이정애와 정향균의 연구대상 558명에 대해 농촌지역 노인들의 인지기능 장애와 사망과의 관련성을 살펴본 결과는 다음과 같다. 1) 3년동안 동안 전체 대상자의 사망률은 558명중 57명인 10.2%이었으며 353명의 정상 인지기능군 중 사망자는 30명으로 사망률 8.5%, 126명 의 경도 인지장애군중 사망자는 14명으로 사망률 11.1%, 79명의 중증 인지장애군중 사망자는 13명으로 사망률 16.5% 이었다(표 3). 2) 3년동안 전체 연구 대상자의 생존율은 0.91이었으며 정상, 경도, 중증 인지기능 장애군의 3년 생존율은 각각 0.92, 0.90, 0.86이었다. 로그 순위 검정법으로 인지기능 정상군과 경도 및 중증의 각 인지기능 장애군의 생존곡선을 비교한 결과 통계적으로 유의하지 않았다. 또한 인지기능 정상군과 경도 이상의 인지기능 장애군간 생존곡선을 비교한 결과도 유의한 차이는 없었다. 3) 혼란변인을 보정하지 않는 Cox의 비례위험 회귀 모형의 단변량분석의 결과 95% 신뢰구간(C.I. : Confidence Interval)에서 사망위험도가 유의한 변인은 연령, 월수입, 흡연습관, 신체장애 등이었으며, 인지기능 장애정도를 정상 그리고 경도 및 중증으로 분류한 분석에서는 정상군에 비해 경도 및 중증의 사망위험도가 유의하게 높지 않았으나, 인지기능 점수(MMSEK score)의 증가에 따른 분석 결과 사망위험도가 0.94로 유의하게 낮게 나타났다(표 4). 4) 잠재적 혼란변인들의 영향을 보정한 Cox의 비례위험 회귀모형의 다변량 분석의 결과 인지기능 장애정도 및 MMSEK 점수증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 5). 5) 남녀별로 각각 인지기능 장애와 사망위험도와의 관계를 알아보기 위해 다변량 분석을 시행한 결과 인지기능 장애정도 및 MMSEK 점수 증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 6, 표 7). 이상 본 연구는 농촌지역 노인들에서 인지기능 장애정도가 사망에 미치는 영향을 알아보고자 하였지만, 인지기능 장애정도가 사망에 미치는 영향을 통계적으로 유의하게 고찰하지 못하였다. The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

농촌지역 노인들의 우울 및 인지기능장애에 관한 연구

이정애,정향균,Rhee, Jung-Ae,Jung, Hyang-Gyun 대한예방의학회 1993 Journal of Preventive Medicine and Public Health Vol.26 No.3

For the purpose of promotion of mental health in the rural elderly, the author surveyed 558 elderlies aged 60 years or more, and assessed the prevalence rates of depression and cognitive impairment by using self-rating depression scale of Zung (SDS) and the Korean version of mini-mental state examination (MMSEK). Also the association between depression or cognitive function and socio-environmental factors were investigated. The major findings were as follows ; 1. The prevalence rates of severe depression and cognitive impairment were 20.9% and 14.9% in all the elderly of both sexes, respectively. 2. The rates of depression and cognitive impairment increased with increasing age in both sex groups. The mean scores of SDS increased and the mean scores of MMSEK decreased significantly among them (p<0.01). 3. Those being female, widows or widowers, and those having low levels of physical activity, showed significantly high the mean scores of depression and had significantly low the mean scores of cognitive impairment (p<0.01). 4. The depression scores relating to decreased libido, confusion, psychomotor retardation, hopelessness and indecisiveness were relatively high in both sexes. 5. All the items of mini-mental state examination were significantly correlated with depression. 6. In stepwise multiple regression analysis on depression, MMSEK, level of physical activity, chronic disease, marital status and family income were selected as highly correlated variables, and the $R^2$-value for these variables was 33.7%. 7. In stepwise multiple regression analysis on cognitive function, level of physical activity, age, depression, sex and marital status were selected as highly correlated variables, and the $R^2$-value for these variables was 62.6%. The depression and cognitive impairment of the elderly were positively correlated with nearly all sociodemographic variables.

환기(換氣)가 불량(不良)한 실내(室內)에서의 간접흡연(間接吸煙)에 관(關)하여

이정애,Rhee, Jung-Ae 대한예방의학회 1981 예방의학회지 Vol.14 No.1

This study was conducted to investigate the effects of passive inhalation of cigarette smoke and the correlation between change of flicker value and active or passive smoking in poorly ventilated room. Forty five male students were tested by divided into four experimental groups composed of active and passive smokers and three control groups. Each four experimental groups were exposed to smoke for Two hours in enclosed room. Vital capacities, flicker values, blood carboxyhemoglobin levels and carbon monoxide concentration in room air were estimated before, during and after the exposure, and amounts of smoking or smoke exposure during two hours were also noted. The results obtained were as follows; 1. Concentration of carbon monoxide in air and increase of blood carboxyhemoglobin level (% COHb) were positively correlated with smoking amount. 2. Increase of blood carboxyhemoglobin in passive smokeres, in average, were about seventy six percent of that in smokers, as 2.2% vs. 2.9%. 3. Comparison with published data showed that Peterson's equation gave most similar result to this study in estimation of increase of blood carboxyhemoglobin level. 4. During the exposure, flicker values fell steadily in both experimental groups and control groups as time passed. Flicker values were, however, elevated again in experimental groups after exposure, despite the fact that values still fell in control groups. 5. Blood carboxyhemoglobin and flicker value were negatively correlated and this correlationship was stronger in passive smoker than in active smoker. 6. Multiple regression equation between flicker value and exposure time and blood carboxyhemoglobin level was expressed as: Flicker value=41.6-0.2 COHb%-0.9Hour, 7. In general, it is suggested that biological criteria would be more preferrable than chemical criteria in establishment of statutory limitation of smoking in enclosed spaces.

예방의학회지를 중심으로 한 예방의학 연구의 동향과 연관련 논문의 질적 메타분석

이정애,박종구,손석준,김춘배,Rhee, Jung-Ae,Park, Jong-Ku,Sohn, Seok-Joon,Kim, Chun-Bae 대한예방의학회 1999 예방의학회지 Vol.32 No.2

Objectives: The purpose of this study was to describe the trends of original research in the Korean Journal of Preventive Medicine, and to evaluate the quality of original articles about lead poisoning. Method: The data for the analysis of trends in preventive medicine research was taker from a total of 829 original articles published in the Korean Journal of Preventive Medicine from 1968 to 1997, The qualitative meta-analysis was measured against a checklist of evaluation criteria, which were divided into 10 categories, with 46 articles on lead poisoning. The evaluation process was performed independently by two evaluators, Results: The number of articles per 100 members over the study period increased by almost 4 pieces in the early 1980s, and by more than 9 pieces in the mid-1990s. In the major classifications of subjects, environmental and industrial health, epidemiology and health statistics, and health policy and management published 370 pieces (44.0%), 137 pisces (16.5%), 322 pieces (38.9%) respectively. In the order of the number of articles, five themes about health significance, including metal exposure (73 pieces), diseases associated with exposure to organic solvents (45 pieces), air pollution (36 pieces), maternal and child health (32 pieces), and occupational health (3D pieces) received consistent attention throughout the years $1968\sim1997$. The overall mean score of article qualify about lead poisoning was 37.8 out of 50. Of the articles any information on the purpose and hypothesis described well, Of those the originality of the subjects, the form of article's (including tables and figures), and the number of inappropriate words of abstracts showed very low score. For multiple regression analyses, the number of joint research institutes and the acceptance of research grants about the article quality were statistically significant. Conclusions: The number of original research reports in the Korean J Prev Med has recently increased and their subjects bave diversified. Of the basis of this study, the articles need improvement in the areas of abstracts, tables and illustrations (figures), etc. The Korean Society for Preventive Medicine will revise contribution regulations for manuscripts submitted to the Korean J Prev Med. Future studies should address these issues and perform the quantitative mata-analysis about the specific subjects including the quality of articles.

B형 간염의 가족집적성과 전파경로에 관한 연구

이정애(Jung Ae Rhee),이명학(Myung Hak Lee) 한국농촌의학 지역보건학회 1992 농촌의학·지역보건 Vol.17 No.2

일부 대학생들에 있어서 생활습관과 신체 및 정신건강도와의 관련성

이정애(Jung Ae-Rhee),이윤지(Youn Ji Lee) 한국농촌의학 지역보건학회 1993 농촌의학·지역보건 Vol.18 No.2

일부 농촌지역 거주 노인들에 대한 포괄적 노인평가

이정애(Jung-Ae Rhee),신희영(Hee-Young Shin),정은경(Eun-Kyung Chung),신준호(Jun-Ho Shin) 한국농촌의학 지역보건학회 2002 농촌의학·지역보건 Vol.27 No.1

전라남도 거주 여성 중 사별군과 비사별군간의 건강행태 비교

최성우,이정애,신준호,신민호,Choi, Seong-Woo,Rhee, Jung-Ae,Shin, Jun-Ho,Shin, Min-Ho 대한예방의학회 2008 예방의학회지 Vol.41 No.4

Objectives: To compare the health behaviors of widowed women with those of currently married women. Methods: We randomly sampled the subjects from the Jeollanamdo Resident Registration Data and we then selected 2,331 widowed women and 4,775 married women. Well-trained examiners measured the height, weight, blood pressure and abdomen circumference, and the women were interviewed with using a questionnaire. Logistic regression analysis was used to estimate the odds ratios(OR) of the two groups. Results: The smoking rate (OR=2.46; 95% confidence interval [CI]1.65, 3.66) was significantly higher for the widowed women. On the contrary, the awareness rate of a smoking cessation campaign (OR=0.80; 95% CI=0.70, 0.92), a quit tobacco telephone line (OR=0.73; 95% CI =0.61, 0.88) and a quit smoking clinic (OR=0.74; 95% CI=0.62, 0.89) were lower for the widowed women. The rate of receiving a health exam (OR=0.80; 95% CI=0.70, 0.91), the rate of undergoing gastric cancer screening (OR=0.77; 95% CI=0.68, 0.88), breast cancer screening (OR=0.79; 95% CI=0.69, 0.89), cervix cancer screening in the last 2 years (OR=0.81; 95% CI=0.71, 0.92), colon cancer screening in the last 5 years (OR=0.74; 95% CI=0.63, 0.87) were significantly lower for the widowed women. Conclusions: This study revealed that the health behaviors are significantly different between the widowed women and the married women. To improve the health behaviors of the widowed women, further study and research that will investigate the socioeconomic and environmental factors that affect the health behaviors of widowed women will be needed.

일부 농촌지역 주민의 코골이와 고혈압의 연관성

최진수,이정애,신희영,Choi, Jin-Su,Rhee, Jung-Ae,Shin, Hee-Young 대한예방의학회 2001 예방의학회지 Vol.34 No.3

본 연구는 지역사회 주민을 대상으로 코골이와 고혈압과의 연관성을 파악하고자 하였다. 일부 전남 농촌지역 역학조사에 참여한 1,763명을 연구대상으로 성별, 연령, 교육수준, 결혼상태, 직업, 흡연 및 음주여부, 고혈압의 유무, 코골이의 유무 등에 대해 직접면접법을 통해 설문조사 하였고 비만은 체질량지수(BMI)로 측정하였다. 고혈압은 측정된 수축기 혈압이 140 mmHg이상이거나 이완기 혈압이 90mmHg이상인 경우와 과거에 고혈압으로 진단 받고 현재 고혈압 치료 중인 경우로 하였다. 코골이 전체 유병률은 41.0%이었고 남자에서 42.7%, 여자에서 39.8%이었다. 연령에 따른 코골이 유병률은 45세-64세 중년층에서 44.3%로 젊은층(33.9%)과 노년층(38.7%)에 비해 높았다. 비만도에 따른 코골이 유병률은 체질량지수가 증가할수록 증가했고 흡연과 음주 여부에 따른 코골이는 유의한 차이가 없었다. 코골이 군에서 코골이가 없는 군보다 고혈압이 많았다(교차비: 1.25, 95% CI=1.01-1.55). 그러나 성별, 연령, 비만, 흡연 및 음주 등의 인자들을 보정한 후 고혈압에 대한 코골이의 유의한 영향은 없었다(교차비: 1.13, 95% CI = 0.90-1.41). 본 연구의 결과는 코골이가 고혈압과 직접적인 연관성이 있기보다는 비만과 같은 교란변수에 의한 효과일 수 있음을 나타낸다. Objectives : To evaluate the association of snoring and hyper-tension in a rural population. Methods : A population-based sample of 1,763 adults in Chonnam, Korea was investigated with questionnaires and height, weight, and blood pressure measurements. Information on the demographic characteristics, cigarette smoking, alcohol consumption, hypertension and snoring was collected through a person-to-person interview using a structured questionnaire. The level of obesity was measured by the body mass index(BMI). Hypertension was considered to be present if the average of two blood pressure measurements was greater than 140mmHg systolic or 90mmHg diastolic, or if they were currently on antihypertensive treatment. Results : The prevalence of snoring was 42.7% in men and 39.8% in women. With regard to age, snoring prevalence was 44.3% in the middle-aged group(45 to 64 years), greater than 33.9% in the younger(<45 years) group or 38.7% in the elderly($\geq65$ years) group. The snoring prevalence increased progressively with increasing BMI, but cigarette smoking and alcohol consumption was not associated with snoring. Hypertension occurred more frequently in snorers than in non-snorers (Odds ratio: 1.25, 95% confidence interval : 1.01-1.55). However after adjusting for sex, age, obesity, smoking, and alcohol use, an effect of snoring on hypertension was no longer present (Odds ratio: 1.13, 95% confidence interval = 0.90-1.41). Conclusion : These results suggest that snoring might not be associated with hypertension.

출생 및 영아사망 신고체계 및 전산정보체계 개발

박정한 ( Jung Han Park ),박순우 ( Soon Woo Park ),전혜리 ( Hae Ri Jun ),이영숙 ( Young Sook Lee ),이정애 ( Jung Ae Rhee ),조현 ( Hyun Cho ),정영해 ( Young Hae Chung ) 한국보건행정학회 1998 보건행정학회지 Vol.8 No.2