지역사회 거주 노인의 동거형태에 따른 인지기능 변화궤적과 영향요인: 고령화연구패널조사 활용
Trajectories of Cognitive Function and Their Associated Factors in Community-Dwelling Older Adults by Living Arrangement Using the Korean Longitudinal Study of Aging
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연구배경: 본 연구는 고령화연구패널조사(Korean Longitudinal Study of Ageing)를 활용하여 지역사회 거주 노인의 동거형태에 따라 8년간의 인지기능 변화 양상을 파악하고, 독거노인과 동거가족이 있는 노인의 인지기능 변화 유형별 영향요인을 파악하고자 시도되었다. 방법: 본 연구의 대상자는 지역사회 거주 65세 이상 노인으로 8년간(2012-2020) 3회 이상 인지기능 측정에 참여한 최종 3,049명의 자료를 분석하였다. 노인의 동거형태에 따른인지기능 변화의 잠재계층 수의 결정은 잠재계층성장모형(latent class growth modeling)으로 분석하였다. 다항 로지스틱 회귀분석을 활용하여 인지기능 변화궤적의 잠재계층 유형별 영향요인을 확인하였다. 결과: 본 연구 결과 독거노인의 경우 ‘높음-유지형(35.6%)’, ‘높음-저하형(32.5%)’, ‘보통-급감형(6.2%)’, ‘낮음-유지형(18.9%)’, ‘낮음-저하형(6.8%)’의 5개 유형의 인지기능 변화양상을 보였다. 동거가족이 있는 노인의 경우 ‘높음-유지형(46.4%)’, ‘높음-저하형(32.0%)’, ‘낮음-유지형(15.9%)’, ‘낮음-저하형(5.7%)’의 4개 유형의 인지기능 변화 양상을 보였다. 독거노인과 동거가족이 있는 노인 모두에서 연령, 도구적 일상생활 수행 능력, 우울이 인지기능 변화 양상의 공통된 영향요인이었다. 단, 독거노인의 경우 가구 월소득이, 동거가족의 경우 성별, 교육 수준, 체질량지수, 규칙적 운동, 일상생활 수행 능력, 직업, 거주지역이 인지기능 변화 양상을 결정짓는 영향요인으로 나타났다. 결론: 본 연구를 통해 동거형태별 노인의 인지기능 변화양상은 다를 수 있음을 확인하였다. 따라서 본 연구 결과를바탕으로 노인의 노년기 동거형태별 인지기능 유지 또는 인지기능 손상 예방을 위한 맞춤형 중재개발을 위한 후속 연구와 보건정책마련이 요구된다.
Abstract
Background: The purpose of this study was to describe the distinct cognitive trajectories for 8 years according to living arrangement among community-dwelling older adults using the Korean longitudinal study of ageing. Methods: We analyzed data from a final sample of 3,049 community-dwelling older adults aged 65 years or older who participated in at least three cognitive function measures in an 8-year period (2012-2020). Cognitive function was assessed by Korean mini mental state examination. Latent class growth model analysis was applied to determine the number and shape of trajectories of older adults according to living arrangement. Multinomial logistic regression analysis was used to determine risk factors for cognitive function trajectories. Results: We identified five trajectory patterns in cognitive function among older adults living alone; ‘high-stable (35.6%)’, ‘high-declining (32.5%)’, ‘moderate-steep declining (6.2%)’, ‘low-stable (18.9%)’, and ‘low declining (6.8%)’. In older adults living with family, there were four trajectory patterns; ‘high-stable (46.4%)’, ‘high-declining (32.0%)’, ‘low-stable (15.9%)’, and ‘low-declining (5.7%)’. Age, instrumental activities of daily living, and depression were common factors of cognitive changes in both older adults living alone and those living with family members. However, monthly incomes was only associated with the risk of cognitive function in older adults living alone. Conclusions: We found that cognitive function trajectories among older adults may differ depending on the type of living arrangement. Therefore, further studies and health policies are required for avoiding cognitive impairment by living arrangement among older adults based on the results of this study
참고문헌 (30)
- "Population prospects of the world and South Korea" (2022)[URL]
- Urtamo A, "Definitions of successful ageing : a brief review of a multidimensional concept", Acta Biomed, 90(2), pp.359~363 (2019)
- Aspell N, "Predicting admission to long-term care and mortality among community-based, dependent older people in Ireland", Int J Geriatr Psychiatry, 34(7), pp.999~1007 (2019)
- Wu Z, "Trajectories of cognitive function in community-dwelling older adults : a longitudinal study of population heterogeneity", Alzheimers Dement(Amst), 13(1), pp.e12180~ (2021)
- "Nationwide survey on the dementia epidemiology of Korea" (2022)[URL]
- Zhang Q, "Changes in cognitive function and risk factors for cognitive impairment of the elderly in China : 2005-2014", Int J Environ Res Public Health, 16(16), pp.2847~ (2019)
- Yaffe K, "Cardiovascular risk factors across the life course and cognitive decline : a pooled cohort study", Neurology, 96(17), pp.e2212~9 (2021)
- Shin J, "Patterns and risk factors of cognitive decline among community-dwelling older adults in South Korea", Arch Gerontol Geriatr, 104, pp.104809~ (2023)
- Hu X, "Cognitive ageing trajectories and mortality of Chinese oldest-old", Arch Gerontol Geriatr, 82, pp.81~87 (2019)
- Chen TY, "Developmental patterns of cognitive function and associated factors among the elderly in Taiwan", Sci Rep, 6, pp.33486~ (2016)
- Wu Z, "Potential modifiable factors associated with late-life cognitive trajectories", Front Neurol, 13, pp.950644~ (2022)
- Srivastava S, "Feeling about living arrangements and associated health outcomes among older adults in India : a cross-sectional study", BMC Public Health, 21(1), pp.1322~ (2021)
- Lee YH, "Transition of living arrangement and cognitive impairment status among Chinese older adults: are they associated?", Medicina (Kaunas), 57(9), pp.961~ (2021)
- Roystonn K, "Living arrangements and cognitive abilities of community-dwelling older adults in Singapore", Psychogeriatrics, 20(5), pp.625~635 (2020)
- Yu Y, "Association between living arrangements and cognitive decline in older adults : a nationally representative longitudinal study in China", BMC Geriatr, 22(1), pp.843~ (2022)
- Yoon D, "Patterns of cognitive function trajectory and their associated factors in Korean older women in single households", Innov Aging, 4(Suppl 1), pp.294~ (2020)
- Desai R, "Living alone and risk of dementia : a systematic review and meta-analysis", Ageing Res Rev, 62, pp.101122~ (2020)
- Vetrano DL, "Trajectories of functional decline in older adults with neuropsychiatric and cardiovascular multimorbidity : a Swedish cohort study", PLoS Med, 15(3), pp.e1002503~ (2018)
- Zhang B, "Heterogeneity in longitudinal trajectories of cognitive performance among middle-aged and older individuals with hypertension : growth mixture modeling across an 8-year cohort study", Hypertens Res, 45(6), pp.1037~1046 (2022)
- "Korean longitudinal study of ageing (KLoSA) basic analysis report" (2022)[URL]
- 김보연, "2020 Korean Society for the Study of Obesity Guidelines for the Management of Obesity in Korea", Journal of Obesity & Metabolic Syndrome, 30(2), pp.81~92 (2021), 대한비만학회[DOI]
- Skou ST, "Multimorbidity", Nat Rev Dis Primers, 8(1), pp.48~ (2022)
- Andresen EM, "Screening for depression in well older adults : evaluation of a short form of the CES-D(center for epidemiologic studies depression scale)", Am J Prev Med, 10(2), pp.77~84 (1994)
- Irwin M, "Screening for depression in the older adult : criterion validity of the 10-item center for epidemiological studies depression scale(CES-D)", Arch Intern Med, 159(15), pp.1701~1704 (1999)
- Kang Y, "A validity study on the Korean mini-mental state examination(K-MMSE)in dementia patients", J Korean Neurol Assoc, 15, pp.300~308 (1997)
- Jung T, "An introduction to latent class growth analysis and growth mixture modeling", Soc Personal Psychol Compass, 2(1), pp.302~317 (2008)
- Howrey BT, "Stability in cognitive function over 18 years : prevalence and predictors among older Mexican Americans", Curr Alzheimer Res, 12(7), pp.614~621 (2015)
- Tu L, "Trajectories of cognitive function and their determinants in older people : 12years of follow-up in the Chinese longitudinal healthy longevity survey", Int Psychogeriatr, 32(6), pp.765~775 (2020)
- Zaninotto P, "Cognitive function trajectories and their determinants in older people : 8 years of follow-up in the english longitudinal study of ageing", J Epidemiol Community Health, 72(8), pp.685~694 (2018)
- Yu M, "Predictors of self-neglect among community-dwelling older adults living alone in China", Geriatr Nurs, 40(5), pp.457~462 (2019)