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.

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

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

B형 간염의 가족집적성과 전파경로에 관한 연구

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

광주지역 남자 중.고등학생의 흡연실태와 흡연관련 요인

이윤지,이정애,Lee, Yun-Ji,Rhee, Jung-Ae 대한예방의학회 1993 예방의학회지 Vol.26 No.3

광주지역 남자 중 고등학생들의 흡연실태와 흡연에 영향을 미칠 것으로 생각되는 사회환경적 요인, 지식 및 태도를 파악하고자 1992년 6월 15일부터 6월 30일까지 본 조사를 실시하였다. 조사대상은 광주지역 남자 중학생은 남녀공학유무, 고등학생은 남녀공학유무 및 인문계와 실업계 계열별로 이단계 층화확률표본추출하였으며 흡연실태에 대한 조사는 구조화된 설문지를 배포하여 자기기입식 방법으로 작성하였다. 응답자는 중학생 1,574명, 인문계 고등학생 1,664명, 실업계 고등학생 721명으로 총 3,959명이며 자료분석결과는 다음과 같다. 1. 현재 흡연자는 중학생은 1.5%, 인문계 고등학생 14.8%, 실업계 고등학생 35.1%로 전체 고등학생의 흡연율은 20.1%를 나타냈으며 중 고등학생 모두 학년이 올라갈수록 흡연자의 비율은 증가하였다(p< 0.01). 2. 과거 및 현재 흡연자의 흡연시작 상황을 보면 중 고등학생 모두 호기심으로부터, 그 다음은 다른 사람이 권했기 때문이라고 응답하였으며 처음 권유한 사람은 대부분이 친구로서 친구가 흡연동기의 많은 영향을 끼치는 것으로 보인다. 3. 현재 흡연자중 매일 규칙적으로 흡연하는 학생은 중학생의 경우 34.8% 였고, 고등학생은 70.2%였다. 흡연 기간은 중학생은 1개월 미만이 29.2%로 가장 많았으며 고등학생은 2년이상의 장기 흡연군이 가장 많았다. 흡연시작시기는 중학생은 국민학교때, 고등학생은 중학교 3학년때 시작하는 경우가 가장 많았고, 금연을 시도했다가 실패한 학생을 합하면 76.8%가 금연의사를 보인 것으로 나타났다. 4. 친한 친구의 흡연, 가족중 어머니와 남자형제의 흡연, 원만하지 못한 친구관계, 가정 학교생활의 불만족, 하위에 속하는 학교성적, 타인의 흡연에 대해 보다 너그러운 태도, 간접흡연에 대한 지식이 없고 TV를 통해 흡연의 유해성을 듣지 못한 경우에 있어서 흡연자가 유의하게 많았다(p<0.01). To identify the smoking status and its related factors in middle and high school boys in Kwanju a study was performed from 15th to loth of June 1992. Population were selected by two-stage stratified random sampling method and total 3,959 students replied to the self-administered questionnaire survey (1,574 in middle school, 1,664 in academic high school, 712 in business high school). The results were as follows ; 1. The proportion of current smokers was 1.5% in middle schools and 20.1% in high schools. And the smoking rates increased with school grade years (p<0.01). 2. For the motivation of smoking, curiosity was the most frequent factor and the next was temptation by friends. 3. The most common situation on the first experience of smoking was that middle school boys smoked a cigarette which was found in a house, through curiosity, with friends, at home. High school boys smoked a cigarette taken from friends, through curiosity, with friend, on the road or at home. 4. The proportion of smokers who smoke a cigarette regularly was 34.8% among smokers in middle school and 70.2% among smokers in high school. The most proportion of duration of smoking was less than 1 month among middle school boys (20.8%) and more than 2 years among high school boys (43.9%). The first smoking experience was in elementary school among middle school boys and the third grade of middle school in high school students. Most current smokers (73.9% in middle school boys, 65.3% in high school boys) wanted to quit smoking. 5. Smokers had significant association with intimate friend's smoking, mother's and brother's smoking, inharmonious friendships, dissatisfied with home and school life, lower school grades, generous attitude to other smokers, lack of knowledge to passive smoking and no contact to mass media (TV) (p<0.01).

새로운 치매 선별검사를 이용한 도시지역 노인의 치매 유병률과 관련요인

신희영,이정애,윤진상,김재민,정은경,Shin, Hee-Young,Rhee, Jung-Ae,Yoon, Jin-Sang,Kim, Jae-Min,Chung, Eun-Kyung 대한예방의학회 2005 예방의학회지 Vol.38 No.3

Objectives : Dementia has rapidly increased with the prolongation of life expectancy and aging in Korea. This study was conducted to estimate the prevalence of, and find related factors for, dementia in an urban elderly population, using a newly developed screening method. Methods : Seven hundred and six people, aged over 65 years-old, in Dong district of Gwangju, Korea, were recruited using stratified cluster sampling, and completed Korean version of Geriatric Mental State Schedule B3 (GMS B3-K), the Korean version of the Community Screening Interview for Dementia (CSID-K) and modified 10 word list-learning from the Consortium to Establish a Registry of Alzheimer's Disease (CERAD). Dementia was diagnosed by an algorithm derived from all three of these measures. Results : The crude and age adjusted prevalence rates of dementia were 13.0 and 11.5%, respectively. Age, education, marital status and a history of cerebrovascular disease were identified as factors related with dementia. Conclusions : The new instrument, using the GMS B3-K, CSID-K and modified 10 word list-learning from the CERAD, was considered effective as a community screening and diagnostic tool for dementia. The results of this study can also be used to develop a community-based prevention and management system for dementia in the future.

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.