Byung-Chan Choi

Background/Objectives: Despite the importance of resistance exercise in older adults, factors associated with participation remain unclear, especially regarding sex differences. This study investigated sociodemographic, behavioral, and comorbidity factors associated with insufficient resistance exercise participation among community-dwelling older adults in Korea, with analyses stratified by sex. Methods: Nationally representative cross-sectional data from 8671 participants aged ≥65 years (3758 men and 4913 women; mean age 72.8) were analyzed using the 6th-8th Korea National Health and Nutrition Examination Surveys (2014–2019). Complex-sample multivariable logistic regression identified factors associated with insufficient resistance exercise overall and by sex. Results: Women had a higher prevalence of insufficient resistance exercise than men (91.27% vs. 71.04%, p < 0.001). Older age groups, particularly those aged ≥80 years (OR: 2.39; 95% CI: 1.86–3.07), and those with lower education (OR: 1.56; 95% CI: 1.33–1.82), rural residence (OR: 1.89; 95% CI: 1.49–2.38), low household income, (OR: 1.45; 95% CI: 1.13–1.88), insufficient aerobic exercise (OR: 1.68; 95% CI: 1.46–1.94), current smoking (OR: 1.70; 95% CI: 1.26–2.29), and diabetes (OR: 1.28; 95% CI: 1.09–1.51) were independently associated with a higher likelihood of insufficient resistance exercise. The association of household income, current smoking, hypertension, and diabetes with resistance exercise adherence showed differences in sex-stratified analyses. Conclusions: Multiple sociodemographic, behavioral, and comorbid factors are linked to resistance exercise adherence among older Koreans. Tailored, sex-specific interventions are needed to promote resistance exercise in this population, informing public health strategies and further research on effective approaches for diverse older adults.

Background: Patients with severe dysphagia are usually fed using a nasogastric tube (NGT). Many patients who receive long-term NGT feeding are unable to obtain sufficient nutrients orally immediately after NGT removal. Thus, a transitional period involving oral diet training is required to transition from NGT feeding to exclusive oral feeding. We aimed to investigate the therapeutic effect of oral diet training in indwelling NGT patients with prolonged dysphagia. Methods: A total of 175 patients who were fed using an NGT for more than 4 weeks were enrolled. Their swallowing function was evaluated by a videofluoroscopic swallowing study (VFSS). During the VFSS, patients received thick and thin barium while the NGT was inserted. Then, the patients underwent a VFSS without an NGT thirty minutes after NGT removal. If a patient had no aspiration with NGT inserted during the VFSS, oral diet training combined with NGT feeding was recommended. Results: Of the 49 indwelling NGT patients who were recommended to receive oral diet training, 39 (79.6%) transitioned to exclusive oral feeding. A transition period of 2–8 weeks was required for them to achieve full oral feeding. Patients who were eligible for oral feeding trials showed no significant aspiration during the VFSS with an NGT inserted and had sufficient cough function. Patients who required prolonged NGT feeding and who could not complete oral trials showed significant aspiration during the VFSS when an NGT was inserted. Conclusions: This study demonstrated that oral diet training combined with NGT feeding is safe in patients with prolonged dysphagia who have sufficient cough function and no aspiration during VFSS. We suggest that if the patient is a proper candidate for NGT removal, direct oral feeding training with an NGT inserted could be a useful therapeutic strategy during the transitional period from long-term NGT feeding to successful oral feeding.

Background Patients with severe dysphagia are usually fed using a nasogastric tube (NGT). Many patients who receive long-term NGT feeding are unable to obtain sufficient nutrients orally immediately after NGT removal. Thus, a transitional period involving oral diet training is required to transition from NGT feeding to exclusive oral feeding. We aimed to investigate the therapeutic effect of oral diet training in indwelling NGT patients with prolonged dysphagia. Methods A total of 175 patients who were fed using an NGT for more than 4 weeks were enrolled. Their swallowing function was evaluated by a videofluoroscopic swallowing study (VFSS). During the VFSS, patients received thick and thin barium while the NGT was insulted. Then, the patients underwent a VFSS without an NGT thirty minutes after NGT removal. If a patient had no aspiration with NGT inserted during the VFSS, oral diet training combined with NGT feeding was recommended. Results Of the 49 indwelling NGT patients who were recommended to receive oral diet training, 39 (79.6%) transitioned to exclusive oral feeding. A transition period of 2-8 weeks was required for them to achieve full oral feeding. Patients who were eligible for oral feeding trials showed no significant aspiration during the VFSS with an NGT inserted and had sufficient cough function. Patients who required prolonged NGT feeding and who could not complete oral trials showed significant aspiration during the VFSS when an NGT was inserted. Conclusion This study demonstrated that oral diet training combined with NGT feeding was safe in patients with prolonged dysphagia who had sufficient cough function and no aspiration during VFSS. We suggest that if the patient is a proper candidate for NGT removal, direct oral feeding training with an NGT inserted could be a useful therapeutic strategy during the transitional period from long-term NGT feeding to successful oral feeding.