Ki Young Son

Dasol Kim, Ki Young Son. Korean J Fam Pract 2026;16:120-6. https://doi.org/10.21215/kjfp.2026.16.2.120

This study aimed to investigate the association of high-density lipoprotein cholesterol (HDL-C) levels with cardiovascular diseases (CVDs) and all-cause mortality and to determine differences based on the presence or absence of a history of CVDs. This retrospective cohort study included 343,321 adults aged ≥ 40 years whose survey data were recorded in the Korean National Health Insurance Service database from 2009 to 2010. HDL-C levels were divided into five groups. The association among HDL-C levels, CVDs, and all-cause mortality was examined using multivariate Cox proportional hazards regression models. During a mean follow-up period of 9.5 ± 2.0 years, CVDs, all-cause mortality, and composite outcomes occurred in 8.3%, 5.9%, and 13.2% of the study population, respectively. HDL-C levels were inversely associated with CVDs and composite outcomes, with a U-shaped association between HDL-C levels and all-cause mortality. Compared with normal HDL-C levels, very low HDL-C levels and very high HDL-C levels were associated with a higher risk of all-cause mortality. Individuals without preexisting CVDs showed similar patterns. Very low HDL-C and low HDL-C levels in individuals with preexisting CVDs were associated with a higher risk of outcomes. Our results suggest that very high HDL-C levels are associated with a decreased risk of CVDs and an increased risk of all-cause mortality. These associations varied according to preexisting CVDs status, sex, and age, challenging the notion that a higher HDL-C level is universally beneficial.

Older adults are at elevated risk of fractures and frequently use multiple medications. Evidence on the association between fracture risk, medication use d

Background: To develop an accurate mortality risk predictive model among patients with lung cancer.Methods: The development cohort included 96,255 patients with lung cancer aged ≥19 years, who underwent a Korean National Health Insurance Service health check-up from 2005 to 2015. The validation cohort consisted of 18,432 patients (≥19 years) with lung cancer from another region. The outcome was all-cause mortality between January 1, 2005, and December 31, 2020.Results: Approximately 60.5% of the development cohort died within a median follow-up period of 2.32 (0.72–5.00) years. Risk score was highest in participants aged ≥65 years, followed by those who underwent treatment, had a history of emergency room visits, and were current smokers. Participants treated by surgery had the lowest risk score, followed by combined surgery and chemotherapy, combined surgery and radiation therapy, women, and regular exercisers. The C statistic in the development and validation cohorts was 0.78 (95% confidence interval, 0.77–0.78) and 0.81 (95% confidence interval, 0.78–0.84), respectively.Conclusion: Advanced age, lung cancer stage, and treatment type were strong risk factors of mortality in lung cancer patients, while being a woman and exercise were preventive factors. These will aid in the prediction of mortality and management of lung cancer patients.

Large-scale studies elucidating sex differences in factors impacting prognosis and sex-specific prognossis factors scoring in patients with lung cancer are insufficient. The present study aimed to develop a model to predict sex-specific prognosis factors in Korean patients with lung cancer. This nationwide cohort study included 96,255 patients aged ≥19 years diagnosed with lung cancer and underwent Korean National Health Insurance Service health examinations between January 1, 2005 and December 31, 2015 and followed until 2020. Factors associated with prognosis were estimated using multivariable Cox proportional hazards regression analyses, and separate prognosis scores were calculated for male and female patients. The sex-specific risk scoring models were validated with Kaplan–Meier survival curves and c-statistic. During a mean follow-up of 2.8 years, 60.5% of the patients died. In male patients with lung cancer, age ≥ 65 years (24 points) had the highest mortality risk score, followed by chemotherapy in combination with radiotherapy (16 points), chemotherapy (14 points), and radiotherapy (11 points). In female patients with lung cancer, chemotherapy in combination with radiotherapy (19 points) had the highest mortality risk score, followed by chemotherapy (16 points), age ≥ 65 years (13 points), and radiotherapy (13 points). The analysis of patients categorized into three risk groups based on risk scores revealed that the fatality rates within 5 years were 7%, 54%, and 89% in the low-, intermediate-, and high-risk groups for male patients and 3%, 46%, 85% in the low-, intermediate-, and high-risk groups for female patients, respectively. The c-statistic was 0.86 for male patients and 0.85 for female patients. The strongest fatality risk factors in lung cancer were age ≥ 65 years in male patients and chemotherapy in female patients. The present study developed sex-specific prognosis scoring models to predict fatality risk in patients with lung cancer.

Background: We aimed to evaluate the association of anticholinergic burden and chronic polypharmacy with the incidence of functional decline and all-cause mortality, and to determine the difference between anticholinergic burden and chronic polypharmacy among Korean older people. Methods: This nationwide cohort study included 42,132 older people aged ≥ 65 years who underwent Korean National Health Insurance Service health examinations from 2007 to 2008. Odds ratios (ORs) and 95% confidence intervals (CIs) for abnormal Timed Up and Go (TUG) test results were assessed using multivariate logistic regression analyses. Hazard ratios (HRs) and 95% CIs for all-cause mortality until the end of 2015 were estimated using multivariable Cox proportional hazards regression analysis. Results: Of the participants, 37.19% had abnormal TUG test results, and 7.66% of those died during the 5.7-year mean follow-up. The abnormal TUG test results OR increased by 27% among individuals with Korean Anticholinergic Burden Scale (KABS) scores ≥ 3 (OR 1.27, 95% CI 1.02–1.58) compared to those with KABS scores of 0. The HRs for all-cause mortality increased for individuals with higher KABS scores (P for trend < 0.001) or chronic polypharmacy (P for trend < 0.001) compared to those for individuals without these conditions. The combination of a higher KABS or chronic polypharmacy and abnormal TUG test results increased the risk of all-cause mortality (All P for trend < 0.001). Conclusion: Anticholinergic drug burden shows a better association with functional decline than chronic polypharmacy, and the use of medications and functional decline may be important risk factors for all-cause mortality among older people.

Ki Young Son*. Korean J Fam Pract 2023;13:67. https://doi.org/10.21215/kjfp.2023.13.2.67

Background: South Korea has no official geriatric specialties or subspecialties. Moreover, studies on the unmet needs related to geriatric health problems in older Korean adults are scarce. Therefore, we investigated the unmet needs regarding geriatric health problems among older Korean adults. Methods: This cross-sectional study included 411 Korean adults aged ≥70 years. We constructed a questionnaire for a field survey that comprised 21 items to understand the geriatric challenges related to the participants’ physicians and the necessity for geriatric physicians to resolve participants’ health problems. We used unweighted numbers (weighted percentages) or mean±standard deviation to describe the characteristics of the study participants for categorical and continuous variables, respectively.Results: This study included a total of 411 men and women. The mean age was 77.6±5.9 years. Among the participants, 88.6% had one or more chronic diseases (mean number of chronic diseases, 2.0±1.3). Of the participants, 32.8% said that their physicians did not spend enough time addressing their problems and only 24.3% felt that their physicians understood geriatric problems well. Of these, 76.2% (n=313) said that geriatricians were required to fulfill their unmet healthcare needs.Conclusions: The participants reported the need for help from a geriatrician, although most of the participants consulted regular physicians about their health problems. The study results support that geriatricians are needed to improve health services for older adults.

AimWe investigated the difference in the relationship between physical activity and low muscle mass resulting from the choice of diagnostic criterion for low muscle mass. MethodsOur study was cross-sectional, using data from the 2008-2011 National Health and Nutrition Examination Survey. Muscle mass was measured by dual-energy X-ray absorptiometry. Low muscle mass was defined as height-adjusted and weight-adjusted low muscle mass. Odds ratios (ORs) and 95% confidence intervals (CIs) of low muscle mass in relation to physical inactivity were analyzed using multivariate logistic regression analysis. ResultsOur study included 3977 older people (1698 men and 2279 women). The prevalence of height-adjusted and weight-adjusted low muscle mass was 4.1% and 11.8%, respectively, in the physically inactive group, and 3.9% and 7.9%, respectively, in the physically active group. The prevalence of weight-adjusted low muscle mass increased by 48% in the physically inactive group in the fully adjusted model (OR, 1.48; 95% CI, 1.13-1.95) and increased by 61% in men and 50% in women (men: OR, 1.61; 95% CI, 1.12-2.31 and women: OR, 1.50; 95% CI, 1.20-2.20) compared with the physically active group. The risk of height-adjusted low muscle mass in men tended to be higher in the physically inactive group than in the physically active group. However, this trend was not observed among women. ConclusionsPhysical inactivity was associated with an increased prevalence of low muscle mass in weight-adjusted measures among elderly adults in Korea. Height-adjusted low muscle mass in women is less useful as an indicator of the relationship between low muscle mass and physical inactivity. Geriatr Gerontol Int 2022; center dot center dot: center dot center dot-center dot center dot.

Objective: To examine the associations between the allergic triad (asthma, allergic rhinitis, atopic dermatitis) and risk of dementia.Methods: Participants comprised 6,785,948 adults aged ≥40 years who participated in a national health examination in 2009 without any history of dementia before baseline. From 2009 to 2017, we prospectively investigated the associations between physician‐diagnosed allergic diseases and risk of incident dementia (all‐cause, Alzheimer's disease [AD], vascular dementia [VaD]) ascertained using national health insurance claims data.Results: During 8.1 years of follow‐up, 260,705 dementia cases (195,739 AD, 32,789 VaD) were identified. Allergic diseases were positively associated with dementia risk. Compared with individuals without allergic diseases, multivariable hazard ratios (HRs) of all‐cause dementia were 1.20 (95% confidence interval [CI] 1.19–1.22) in those with asthma, 1.10 (95% CI 1.09–1.12) with allergic rhinitis, 1.16 (95% CI 1.11–1.21) with atopic dermatitis, and 1.13 (95% CI 1.12–1.14) with any of these allergies. Similarly, individuals with any of the allergic triad had a higher risk of AD (HR 1.16, 95% CI 1.14–1.17) and VaD (HR 1.04; 95% CI 1.01–1.06) than those without any allergic disease. As the number of comorbid allergic diseases increased, the risk of dementia increased linearly (P_trend ≤ 0.002). Compared with individuals without allergies, those with all three allergic diseases had substantially increased risk of all‐cause dementia (HR 1.54, 95% CI 1.35–1.75), AD (HR 1.46; 95% CI 1.25–1.70), and VaD (HR 1.99, 95% CI 1.44–2.75).Interpretation: Asthma, allergic rhinitis, and atopic dermatitis were significantly associated with increased risk of all‐cause dementia and subtypes, with dose–effect relationships with the severity of allergic diseases. ANN NEUROL 2023;93:384–397