Park E. J Korean Acad Nurs. 2008 Jun;38(3):465-473. https://doi.org/10.4040/jkan.2008.38.3.465

Background: People with chronic diseases may experience poor cognitive functioning associated with advanced age, progression of disease, or other comorbid chronic conditions. Empirical evidence of this phenomenon is limited despite the clinical relevance of cognitive decline and associated adverse outcomes such as poor physical functioning. Purpose: The purpose of this study was to examine cognitive functioning in the domains of memory, attention, and executive function and its association with functional capacity in a sample of community-dwelling adults with a spectrum of chronic diseases. Methods: An exploratory cross-sectional study was conducted in a sample of community-dwelling adults with chronic diseases, including hypertension (58.9%), diabetes mellitus (DM; 20.0%), and dyslipidemia (14.4%). Participants’ mean age was 64.1 ± 11.2 years, and 48.9% were male. Ninety persons completed the face-to-face interviews, which evaluated cognitive functioning in the domains of memory, attention, and executive function using neuropsychological tests and the physical well-being test, which measured functional capacity using the Duke Activity Status Index. Results: Compared with those with other chronic diseases, our sample with hypertension and DM had significantly more memory loss and poorer executive function. These significant differences were nullified when adjusting for age, gender, and education. Approximately one third had functional limitations (n = 29, 32.2%), using a cutoff point of 35 or less (Duke Activity Status Index). Memory loss (delayed recall, b = 1.5, p = .016) and poor executive function (Trail Making Test Part A, b = −0.2, p < .001) were predicting factors of functional decline, independent of age, gender, education, and comorbidity. Conclusions/Implications for Practice: Cognitive function, particularly memory and executive function, was poorer among chronically ill Korean adults in the community with hypertension or DM than their counterparts. Functional decline was worse in the presence of memory loss and poor executive function. Studies examining the mechanism by which overall functioning is impacted by cognitive decline and its relevance to functional declines in a larger representative sample are warranted.

Despite the growing prevalence of metabolic syndrome (MetS) in Korea, information is lacking on gender- and age-specific patterns in prevalence of MetS among Korean adults. The aims of this study were to examine (1) gender-specific prevalence of MetS by its component abnormalities, (2) the prevalence of MetS and its component abnormalities by gender and 10-year age groups, and (3) gender-specific lifestyle risk factors for MetS presentation among Korean adults. A secondary data analysis was performed using the most recent national survey. A sample group of 5760 adults (mean age, 44.6 ± 0.46 years; 43.5% men) completed household interviews to provide blood (for high-density lipoprotein cholesterol, triglyceride, and glucose) and anthropometric measurements (ie, waist circumference, weight, and height) to define MetS, as well as data on lifestyle risk factors. Approximately 1 in 4 Korean adults met the MetS diagnostic criteria. Given each component abnormality, MetS was the most prevalent in men with low high-density lipoprotein cholesterol (63.4%), followed by abdominal obesity (62.3%). In women, it was most prevalent in those with hypertriglyceridemia (73.2%), followed by hyperglycemia (69.7%). Metabolic syndrome showed an association with advanced age for both men and women (P < .001 for both), with greater prevalence of MetS in young and middle-aged men than in women (6.7%-39.9% vs 3.3%-36.4%); these patterns were reversed in people 60 years or older (34.0%-40.5% vs 55.2%-64.1%). Gender-specific lifestyle risk factors for MetS presentation showed a significant association with heavy alcohol drinking and obesity for both men (odds ratio, 1.65 and 5.26, respectively; P < .001 for both) and women (odds ratio, 1.96 and 5.94; P < .042 and < .001, respectively). Metabolic syndrome is prevalent in a representative sample of Korean adults, with gender- and age-specific patterns. These results are helpful in identification of vulnerable subgroups at high risk for MetS, providing a basis for promotion of cardiovascular health and risk management of MetS.