Dement Neurocogn Disord.  2017 Mar;16(1):12-19. 10.12779/dnd.2017.16.1.12.

Factors Affecting Cognitive Impairment and Depression in the Elderly Who Live Alone: Cases in Daejeon Metropolitan City

• Lee J
• Ham MJ
• Pyeon JY
• Oh E
• Jeong SH
• Sohn EH
• Lee AY

• KMID: 2442830
• DOI: http://doi.org/10.12779/dnd.2017.16.1.12

Abstract

BACKGROUND AND PURPOSE
With the rapid increase in the number of elderly people in Korea, multiple socio-economic problems have emerged. In 2015, 6.4 million people accounting for about 13% of the total population in Korea were aged 65 years and over. As the elderly population continues to grow, the elderly who live alone are also increasing. They have potential risks in medical and neuropsychological aspects. The purpose of this study was to investigate the association between cognition and socio-environmental status in the elderly who live alone.
METHODS
This study was conducted on 512 people who live alone (equivalent to 1% of the total elderly people) in Daejeon Metropolitan City between April and November 2015. Structured questionnaires were used to investigate the general characteristics, socio-economic status, physical status, and mood for participants. Simple tests using Mini-Mental Status Examination-Demetia Screening, Geriatric Depression Scale and Korean-instrumental activities of daily living were also performed.
RESULTS
Among the 512 participants, 109 participants (21.3%) had cognitive impairment, and 128 participants (25.0%) had depression. The number of daily meals, frequency of meeting with family, and depression were independent risk factors for cognitive impairment. Factors including the duration of living alone, cognitive impairment, poor self-perceived health status, frequency of meeting with family and duration of education were considered an independent risk factor for depression.
CONCLUSIONS
This study showed that the elderly who live alone are susceptible to cognitive impairment and depression, and factors including the number of daily meals, social contact, and self-perceived health status may affect cognition and depressive mood. Thus, physicians need to pay attention to management of major factors that may cause cognition impairment and depression in the elderly who live alone; in addition, they require ongoing community interest and support.

Keyword

the elderly who live alone; cognitive impairment; depression; factors

MeSH Terms

Activities of Daily Living
Aged*
Cognition
Cognition Disorders*
Depression*
Education
Humans
Korea
Mass Screening
Meals
Risk Factors

Reference

1. Statistics Korea. 2011 estimated future population 2010-2060. cited 2015 June 14. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=252623.

2. Kim TH, Jhoo JH, Park JH, Kim JL, Ryu SH, Moon SW, et al. Korean version of mini mental status examination for dementia screening and its' short form. Psychiatry Investig. 2010; 7:102–108.

3. Jung IK, Kwak DI, Joe SH, Lee HS. A study of standardization of Korean form of Geriatric Depression Scale (KGDS). J Korean Geriatr Psychiatry. 1997; 1:61–72.

4. Kang SJ, Choi SH, Lee BH, Kwon JC, Na DL, Han SH. Korean Dementia Research Group. The reliability and validity of the Korean instrumental Activities of Daily Living (K-IADL). J Korean Neurol Assoc. 2002; 20:8–14.

5. Han JW, Kim TH, Jhoo JH, Park JH, Kim JL, Ryu SH, et al. A normative study of the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and its short form (SMMSE-DS) in the Korean elderly. J Korean Geriatr Psychiatry. 2010; 14:27–37.

6. Fukunaga R, Abe Y, Nakagawa Y, Koyama A, Fujise N, Ikeda M. Living alone is associated with depression among the elderly in a rural community in Japan. Psychogeriatrics. 2012; 12:179–185.

7. Yang YJ. Mild cognitive impairment and nutrition in old adults. Hanyang Med Rev. 2014; 34:53–59.

8. van Asselt DZ, Pasman JW, van Lier HJ, Vingerhoets DM, Poels PJ, Kuin Y, et al. Cobalamin supplementation improves cognitive and cerebral function in older, cobalamin-deficient persons. J Gerontol A Biol Sci Med Sci. 2001; 56:M775–M779.

9. Kwok T, Tang C, Woo J, Lai WK, Law LK, Pang CP. Randomized trial of the effect of supplementation on the cognitive function of older people with subnormal cobalamin levels. Int J Geriatr Psychiatry. 1998; 13:611–616.

10. Naseer M, Forssell H, Fagerström C. Malnutrition, functional ability and mortality among older people aged ≥60 years: a 7-year longitudinal study. Eur J Clin Nutr. 2016; 70:399–404.

11. Donovan NJ, Wu Q, Rentz DM, Sperling RA, Marshall GA, Glymour MM. Loneliness, depression and cognitive function in older U.S. adults. Int J Geriatr Psychiatry. 2016; 05. 09. [Epub ahead of print]. DOI: 10.1002/gps.4495.

12. Shankar A, Hamer M, McMunn A, Steptoe A. Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing. Psychosom Med. 2013; 75:161–170.

13. Schmand B, Smit J, Lindeboom J, Smits C, Hooijer C, Jonker C, et al. Low education is a genuine risk factor for accelerated memory decline and dementia. J Clin Epidemiol. 1997; 50:1025–1033.

14. Lee S, Hong GR. Predictors of depression among community-dwelling older women living alone in Korea. Arch Psychiatr Nurs. 2016; 30:513–520.

15. Han HK, Lee YR. A study on factors impacting on the mental health level of the elderly people living alone. J Korean Gerontol Soc. 2009; 29:805–822.

16. Aung MN, Moolphate S, Aung TN, Katonyoo C, Khamchai S, Wannakrairot P. The social network index and its relation to later-life depression among the elderly aged ≥80 years in Northern Thailand. Clin Interv Aging. 2016; 11:1067–1074.

17. Kwon MJ, Kim YJ. Analysis of convergent factors on subjective health status of patients with depression. J Digit Converg. 2016; 14:309–316.

18. Cho MJ, Lee JY, Kim BS, Lee HW, Sohn JH. Prevalence of the major mental disorders among the Korean elderly. J Korean Med Sci. 2011; 26:1–10.

19. Suh GH, Kim JK, Yeon BK, Park SK, Yoo KY, Yang BK, et al. Prevalence and risk factors of dementia and depression in the elderly. J Korean Neuropsychiatr Assoc. 2000; 39:809–824.