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장애인의 정신건강 및 신체활동과 모든 원인 사망의 연관성: 고령화패널연구조사의 14년간 추적조사를 바탕으로

Association of Mental Health and Physical Activity with All-cause Mortality in Persons with Disability: Based on 14-year Follow-up Data from the Korean Longitudinal Study of Aging

이인환
국민체육진흥공단 한국스포츠과학원 (Korea Institute of Sport Science)|2022.09|체육과학연구 (Korean Journal of Sport Science)|제33권 제3호|pp. 330-339

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정신건강장애인신체활동Mental healthPhysical activityFollow-up추적조사All-cause mortality모든 원인 사망Persons with disability
주제분류체육

초록

[목적] 본 연구의 목적은 장애인의 인지기능 저하 및 우울증으로 인한 사망 위험에 대해 신체활동이 어떠한 역할을 하는지 검증하는 것을 주요 목적으로 하였다. [방법] 고령화연구패널조사에 참여한 45세 이상 장애인 595명(여성 39.3%)을 대상으로 하였으며, 설문지에 근거하여 인지기능 저하 및 우울증상으로 집단을 세분화하였다. 또한, 신체활동은 주당 150분을 기준으로 신체활동 충분집단과 부족 집단으로 분류하였다. 콕스비례위험회귀모델을 이용하여 정신건강 및 신체활동 수준에 따른 모든 원인사망 위험비(HR, hazard ratio)를 95% 신뢰구간(CI, confidence interval)에서 산출하였다. [결과] 전체 대상자의 평균 추적기간은 11.8±4.1년 사망률은 36.6%(n =218)로 나타났으며, 신체활동 부족 집단은신체활동 충분 집단에 비해 인지기능 저하(p =0.046), 우울증상(p =0.001), 사망(p =0.037)이 유의하게 높은 것으로나타났다. 또한, 신체활동 충분 집단에서는 인지기능 및 우울증상에 따른 사망 위험에 차이가 없었던 반면, 신체활동부족 집단에서는 정상 집단(HR=1)에 비해 인지기능 저하(HR=2.229, 95% CI=1.645-3.020, p <0.001) 및 우울증상집단(HR=1.542, 95% CI=1.136-2.091, p =0.005)의 사망 위험이 유의하게 높은 것으로 나타났다. [결론] 규칙적인 신체활동 및 운동은 중·노년 장애인의 정신건강 유지 및 사망 위험을 감소하는데 핵심적인 요인이 될수 있을 것으로 생각된다.

Abstract

PURPOSE This study investigated the associations between mental health and physical activity with all-cause mortality in persons with disability. METHODS A total of 595 participants (39.3% women) aged 45≥ years, who participated in the Korean longitudinal study of aging (KLoSA) were included in this study. The Korean version of mini-mental state examination (K-MMSE) and the center for epidemiologic studies depression scale (CES-D) were used to assess cognitive impairment and depressive symptoms, respectively. The participants were classified into active and inactive groups based on physical activity of 150 min/week. Cox’s proportional regression analyses were used to determine the hazard ratio (HR) and 95% confidence interval (CI) of mental health and physical activity relating to all-cause mortality. RESULTS During the follow-up period (11.8±4.1 years), a total of 218 (36.6%) deaths occurred from all-causes. Participants in the inactive group had significantly higher cognitive impairment (p =0.046), depressive symptoms (p =0.001), and all-cause mortality (p=0.037) than those in the active group. Compared to participants in the normal (HR=1), cognitive impairment (HR=2.229, 95% CI=1.645-3.020, p <0.001), and depressive symptoms groups (HR=1.542, 95% CI=1.136-2.091, p<0.001), those in the inactive group had significantly higher HR related to all-cause mortality. However, in the active group, cognitive function and depressive symptoms were not associated with all-cause mortality. CONCLUSIONS The current finding suggests that the promotion of physical activity may play an important role in preventing premature death from all-causes in persons with disability, especially among those with mental health problems.

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