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Gender differences in healthy lifestyle clusters and their relationship with depressive symptoms among middle-aged and older adults in Korea
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 Title & Authors
Gender differences in healthy lifestyle clusters and their relationship with depressive symptoms among middle-aged and older adults in Korea
Park, Young Shin; Kim, Hongsoo;
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Objectives: This study was to examine by gender the clustering patterns and correlates of healthy lifestyle clusters and the relationships between healthy lifestyle clusters and depressive symptoms in middle-aged and older adults. Methods: The observed/expected ratio of physical activity, smoking, and alcohol consumption were calculated to analyze clustering effects. The correlates of those healthy lifestyle clusters were evaluated using logistic regression models, and the relationship between those healthy lifestyle clusters and depressive symptoms was investigated using multiple regressions by gender. Results: Based on the guidelines this study adopted, we obtained three healthy lifestyle clusters: active healthy lifestyle; passive healthy lifestyle; and unhealthy lifestyle. All three clusters were found in men, but two in women, who did not have an unhealthy lifestyle cluster. High socio-economic status was positively related to healthy lifestyle clusters. Social participation and residence location (in men) and marital status (in women) were significant factors. Having an active or a passive healthy lifestyle was negatively associated with depressive symptoms in women, but such a relationship was not observed in men. Conclusions: The study findings imply that health promotion programs for middle-aged and older adults in Korea should be comprehensive and integrated, considering healthy lifestyle clusters and gender differences.
lifestyle clustering;depressive symptoms;middle-aged and older adults;
 Cited by
성인의 만성질환 관련 건강위험행태요인 군집현상 분석,이예지;강지완;김지예;나은희;김유리;고광석;이민수;김혜경;

보건교육건강증진학회지, 2017. vol.34. 3, pp.21-31 crossref(new window)
Back, J. H., & Lee, Y. (2011). Gender differences in the association between socioeconomic status(SES) and depressive symptoms in older adults. Archives of Gerontology and Geriatrics, 52(3), e140-e144. crossref(new window)

Bird, C. E., & Rieker, P. P. (2008). Gender and health: The effects of constrained choices and social policies. New York: Cambridge University Press.

Blake, H., Mo, P., Malik, S., & Thomas, S. (2009). How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review. Clinical Rehabilitation, 23(10), 873-887. crossref(new window)

Bots, S., Tijhuis, M., Giampaoli, S., Gromhout, D., & Nissinen, A. (2008). Lifestyle and diet-related factors in late-life depression-a 5-year follow-up of elderly European men: the FINE study. International Journal of Geriatric Psychiatry, 23(5), 478-484. crossref(new window)

Cassidy, K., Kotynia-English, R., Acres, J., Flicker, L., Lautenschlager, N. T., Almeida, O. P., & Lautenschlager, N. T. (2004). Association between lifestyle factors and mental health measures among community-dwelling older women. Australian and New Zealand Journal of Psychiatry, 38(11-12), 940-947. crossref(new window)

Chon, K. K., & Rhee, M. K. (1992). Preliminary development of Korean version of CES-D. Korean Journal of Clinical Psychology, 11(1), 65-76.

ELSA-English Longitudinal Study of Ageing. (n.d.). Retrieved from

Fogelholm, M., Valve, R., Absetz, P., Heinonen, H., Uutela, A., Patja, K., & Jallinoja, P. (2006). Rural-urban differences in health and health behaviour: a baseline description of a community health-promotion programme for the elderly. Scandinavian Journal of Public Health, 34(6), 632-640. crossref(new window)

Glasgow, R. E., Goldstein, M. G., Ockene, J. K., & Pronk, N. P. (2004). Translating what we have learned into practice. Principles and hypotheses for interventions addressing multiple behaviors in primary care. American Journal of Preventive Medicine, 27(2), 88-101. crossref(new window)

Goldstein, M. G., Whitlock, E. P., DePue, J., & Planning Committee of the Addresssing Multiple Behavioral Risk Factors in Primary Care Project. (2004). Multiple behavioral risk factor interventions in primary care: summary of research evidence. American Journal of Preventive Medicine, 27(2), 61-79. crossref(new window)

Harrington, J., Perry, I. J., Lutomski, J., Fitzgerald, A. P., Sheily, F., McGee, H., & Shelley, E. (2009). Living longer and feeling better: healthy lifestyle, self-rated health, obesity and depression in Ireland. The European Journal of Public Health, ckp 102.

HRS-Health and Retirement Study: Introduction to the Study. (n.d.). Retrieved from

Jeon, G. S., Jang, S. N., Kim, D. S., & Cho, S. I. (2013). Widowhood and depressive symptoms among Korean elders: The role of social ties. Journal of Gerontology. Series B: Psychological Sciences and Social Sciences, 68(6), 963-973. crossref(new window)

Jeon, J. Y. W., Yoo, S., & Kim, H. (2012). Clustering patterns and correlates of multiple health behaviors in middle-aged Koreans with metabolic syndrome. Korean Journal of Health Education Promotion, 29(2), 93-105.

Jun, J., Park, H., & Sohn, S. (2013). Trajectories of Korean Adults' Depressive Symptoms and its Associations with Smoking and Drinking: Using Latent Class Growth Modeling. Mental Health & Social Work, 30, 68-94.

Kang, E. J. (2007). Clustering of lifestyle behaviors of Korean adults using smoking, drinking, and physical activity. Health and Social Welfare Review, 27(2), 44-66. crossref(new window)

Kang, H., & Cho, Y. (2007). Socioeconomic status, social integration, and health inequalities of elderly Koreans. Korean Journal of Sociology, 41(4), 164-201.

Kang, K., Sung, J., & Kim, C. H. (2010). High risk groups in health behavior defined by clustering of smoking, alcohol, and exercise habits: National Health and Nutrition Examination Survey. Journal of Preventive Medicine and Public Health, 43(1), 73-83. crossref(new window)

Katsumata, Y., Arai, A., Ishida, K., Tomimori, M., Denda, K., & Tamashiro, H. (2005). Gender difference in contributions of risk factors to depressive symptoms among the elderly persons dwelling in a community, Japan. International Journal of Geriatric Psychiatry, 20(11), 1084-1089. crossref(new window)

Khaw, K. T., Wareham, N., Bingham, S., Welch, A., Luben, R., & Day, N. (2008). Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Medicine, 5(1), e12. crossref(new window)

Kim, T. M., Lee, S. G., & Jeon, S. Y. (2006). The relations of social support to the health behaviors and health status in the elderly. Journal of Korean Society for Health Education and Promotion, 23(3), 99-119.

Kim, Y. J., & Hong, H. (2009). Factors related to the quality of life of mid-old age working women and housewives. Korean Journal of Social Welfare Research, 21, 93-118.

Knoops, K. T., de Groot, L. C., Kromhout, D., Perrin, A. E., Moreiras-Varela, O., Menotti, A., & Van Staveren, W. A. (2004). Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. Journal of American Medical Association, 292(12), 1433-1439. crossref(new window)

Ko, K. D., Cho, Y. T., Cho, S. I., Sung, J. H., Cho, B. L., Son, K. Y., & Choi, H. C. (2012). Association of health risk behaviors with mental health among elderly Koreans. Journal of the Korean Geriatrics Society, 16(2), 66-73. crossref(new window)

Korea Institute for Health and Social Affairs. (2014). Prevalence of multimorbidity and transitional patterns of chronic diseases among Korean adults. Sejong, Korea: Author.

Lee, J. C., Park, J. S., & Kim, G, H. (2010). Factors associated with the health promotion activities of the Korean elderly. Korean Journal of Health Education and Promotion, 27(2), 121-139.

Lee, Y., Back, J. H., Kim, J., Byeon, H., Kim, S., & Ryu, M. (2012). Clustering of multiple healthy lifestyles among older Korean adults living in the community. Geriatrrics & Gerontology International, 12(3), 515-523. crossref(new window)

Ministry of Health and Welfare. (2011). National health plan 2010. Sejong, Korea: Author.

Ministry of Health and Welfare. Korea Institute for Health and Social Affairs. (2012). The survey of living conditions and welfare needs of Korean older persons. Seoul, Korea: Author.

Mirowsky, J. (1996). Age and the gender in depression. Journal of Health and Social Behavior, 37(4), 362-380. crossref(new window)

Ostilin, P., Eckermann, E., Mishra, U. S., Nkowane, M., & Wallstam, E. (2006). Gender and health promotion: A multisectoral policy approach. Health Promotion International, 21(suppl 1), 25-35. crossref(new window)

Park, E., Jun, J., & Kim, N. (2015). The association of multiple risky health behaviors with self-reported poor health, stress, and depressive symptom. Health and Social Welfare Review, 35(1), 136-157. crossref(new window)

Poortinga, W. (2007). The prevalence and clustering of four major lifestyle risk factors in an English adult population. Preventive Medicine, 44(2), 124-128. crossref(new window)

Pronk, N. P., Anderson, L. H., Crain, A. L., Martinson, B. C., O'Connor, P. J., Sherwood, N. E., & Whitebird, R. R. (2004). Meeting recommendations for multiple healthy lifestyle factors: prevalence, clustering, and predictors among adolescent, adult, and senior health plan members. American journal of preventive medicine, 27(2), 25-33. crossref(new window)

Robinson, S. M., Jameson, K. A., Syddall, H. E., Dennison, E. M., Cooper, C., & Aihie Sayer, A. (2013). Clustering of lifestyle risk factors and poor physical function in older adults: The Hertfordshire Cohort Study. Journal of the American Geriatrics Society, 61(10), 1684-1691. crossref(new window)

Scheid, T. L., & Brown, T. N. (Eds.). (2010). A handbook for the study of mental health: Social contexts, Theories, and Systems. (2nd ed.). New York: Cambridge University Press.

Schuit, A. J., van Loon, A. J. M., Tijhuis, M., & Ocke, M. C. (2002). Clustering of lifestyle risk factors in a general adult population. Preventive medicine, 35(3), 219-224. crossref(new window)

Spring, B., Moller, A. C., & Coons, M. J. (2012) Multiple health behaviours: overview and implications. Journal of Public Health, 34(suppl 1), i3-i10. crossref(new window)

Stanfeld, S. A., Head, J., Fuhrer, R., Wardle, J., & Cattell, V. (2003). Social inequalities in depressive symptoms and physical functioning in the Whitehall II study: exploring a common cause explanation. Journal of Epidemiology and Community Health, 57(5), 361-367. crossref(new window)

Statistics Korea. (2009). Older adults statistics. Daejeon, Korea: Author.

Umberson, D. (1992). Gender, marital status and the social control of health behavior. Social science & medicine, 34(8), 907-917. crossref(new window)

U.S. Census Bureau. (2013). Insecure and Unequal: Poverty and Income among Women and Families, 2000-2012. Washington, DC: National Women's Law Center.

U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. (2010). Rethinking drinking: Alcohol and your health. (NIH Publication No. 15-3770). Retrieved from

Van Gool, C. H., Kempen, G. I., Bosma, H., van Boxtel, M. P., Jolles, J., & van Eijk, J. T. (2007). Associations between lifestyle and depressed mood: longitudinal results from the Maastricht Aging Study. American Journal of Public Health, 97(5), 887-894. crossref(new window)

World Health Organization. (2010). Global Recommendations on Physical activity for health. Switzerland: WHO Press.

World Health Organization. (2015, January). Noncommunicable disease. Retrieved from

Yoon, M. S., & Cho, H. J. (2007). A study on the prevalence and predictors of alcohol use, problem drinking among the elderly. Mental Health & Social Work, 26, 254-28