고령인구 비율이 높은 지역 장년, 노년층의 건강.영양상태 및 이에 영향을 미치는 인자에 관한 연구 - III. 농촌노인의 주관적 건강평가와 건강관련행동 및 식이섭취와의 관련성 -

Nutritional Status and Related Factors of the Elderly in Longevity Areas - III. Relation among Self-rated Health, Health-related Behaviors, and Nutrient Intake in Rural Elderly -

  • 최정숙 (농촌진흥청 농촌자원개발연구소) ;
  • 권성옥 (농촌진흥청 농촌자원개발연구소) ;
  • 백희영 (서울대학교 식품영양학과)
  • Choe Jeong-Sook (National Rural Resources Development Institute, RDA) ;
  • Kwon Sung-Ok (National Rural Resources Development Institute, RDA) ;
  • Paik Hee-Young (Department of Food and Nutrition, Seoul National University)
  • 발행 : 2006.04.01

초록

The study aimed to identify major factors related to global self-rated health of the community-dwelling elderly people in rural areas. Interviews were conducted with 433 persons over 65 years of age. The socio-economic characteristics, chronic disease status, measures of functional and mental health, life satisfaction, health-related behaviors including smoking, drinking, exercise, social activity, dietary habit, and food intakes were analyzed to determine their influence on self-rated health index. Data on food intake were obtained through the 24-hour recall method. The self-rated health of rural elderly was poor or very poor as reported by 42.6% and 52.4% of the men and women, respectively. Poor self-rated health was found to be related to elderly aged $65{\sim}74$, female, absence of work, more chronic diseases, dependence on Instrumental Activity Daily Living (IADL), higher mental unhealthy days, lower current life satisfaction, less social activity, lower dietary habit scores, lower intake of total food, fruit, eggs, fishes & shell fishes, vitamin C (%RDA), and Nutrient Adequacy Ratio (NAR). The results of the multiple regression analysis showed that poor self-rated health index is significantly associated with more chronic diseases, mental unhealthy days, gastrointestinal disease, musculoskeletal disease, less social activity, and lower intake of fruits. The results also suggested that improving the nutritional status and functional ability, and reducing the burden of chronic diseases are beneficial to the self-rated health index of the elderly.

키워드

참고문헌

  1. Korea National Statistical Office. Statistic of the older population 2004, 2004
  2. Lee YH, Choi KS, Kang IO. Determinants of self-rated health among the Korean elderly living in the community. Journal of the Korea Gerontological Society 18(2): 110-124, 1998
  3. Farmer MM, Ferraro KF. Distress and perceived health: mechanism of health decline. J Health Soc Behav 39(September): 298-311, 1997
  4. Idler EL, Kasl SV. Health perceptions and survival: do global evaluations of health status really predict mortality. J Gerontol Soc Sci 46(2): S55-65, 1991
  5. Vuorisalmi M, Lintonen T, Jylha M. Global self-rated health data from a longitudinal study predicted mortality better than comparative self-rated health in old age. J Clin Epidemiol 58(7): 680- 687, 2005 https://doi.org/10.1016/j.jclinepi.2004.11.025
  6. Goldman N, Glei DA, Chang M. The Role of Clinical Risk Factors in Understanding Self-rated Health. Ann Epideminol 14: 49-57, 2004 https://doi.org/10.1016/S1047-2797(03)00077-2
  7. Hirdes JP, Forbes WF. Factors associated with the maintenance of good self-rated health. J Aging Health 5: 101-122, 1993 https://doi.org/10.1177/089826439300500105
  8. Hoeymans N, Fesdens EJM, van den Bos GAM, Kronhout D. Age, time, and cohort effects on functional status and self-rated health in elderly men. Am J Public Health 87(10): 1620-1625, 1997 https://doi.org/10.2105/AJPH.87.10.1620
  9. Cockerham WC, Sharp K, Wilcox JA. Aging and perceived health status. J Gerontol 38(3): 349-355, 1983 https://doi.org/10.1093/geronj/38.3.349
  10. Mulsant BH, Ganguli M, Seaberg EC. The relationship between self-rated health and depressive symptoms in an epidemiological sample of community-dwelling older adults. J Am Geriatr Soc 45: 954-958, 1997 https://doi.org/10.1111/j.1532-5415.1997.tb02966.x
  11. Eggenbeen D, Lichter D. Health and well-being among rural Americans: Variations across the life source. J Rural Health 9(2): 86-98, 1993 https://doi.org/10.1111/j.1748-0361.1993.tb00501.x
  12. Kennedy BP, Kawachi I, Glass R, Prothrow-Stith D. Income distribution, socioeconomic status, and self rated health in the United States: Multilevel analysis. Br Med J 317: 917-921, 1998 https://doi.org/10.1136/bmj.317.7163.917
  13. Ferrao KF, Yu Y. Body weight and self-rating of health. J Health Soc Behav 36: 274-284, 1995 https://doi.org/10.2307/2137343
  14. Heikkinen E, Leinonen R, Berg S, Schroll M, Steen B. Levels and associates of self-rated health among 75-year-old people living in three Nordic licalities. In E. Heikkinen S, Berg M, Schroll B, Steen A. Viidik (Eds.) Functional status, health and aging: The NORA study. Facts, Research and Intercention in Geriatrics, pp.121-148, Serdi Publisher. Paris, 1997
  15. Molarius A, Janson S. Self-rated health, chronic diseases, and symptoms among middle-aged and elderly men and women. J Clin Epidemiol 55(4): 364-370, 2002 https://doi.org/10.1016/S0895-4356(01)00491-7
  16. Krause NM, Jay GM. What do global self-rated items measure? Med Care 32(9): 930-942, 1994 https://doi.org/10.1097/00005650-199409000-00004
  17. Speake D, Cowart M, Pellet K. Health perceptions and lifestyles of the elderly. Res Nurs Health 12: 93-100, 1989 https://doi.org/10.1002/nur.4770120206
  18. Walker S, Volkan K, Sechrist K, Pender N. Health-promoting lifestyles of older adults: Comparisons with young and middleaged adults, correlates and patterns. ANS Adv Nurs Sci 11(1): 76-90, 1988 https://doi.org/10.1097/00012272-198810000-00008
  19. Kwon JH, Lee SK, Lee HK, Kim GJ. The relationship between chewing ability and nutritional intake status in the elderly of rural community. Korean J Community Nutrition 3(4): 583-593, 1998
  20. Lee HS, Lee JA, Ahn SY, Kang KJ. A study on health related and eating behaviors by self-recognized health status. Korean J Nutrition 6(3): 340-353, 2001
  21. Min KJ, Kim KJ, Cha CG. A Study on the Factor s Affecting Subjective Health Index of the Aged in Daejon Area. J Korean Society for Health Education and Promotion 18(2): 1-26, 2001
  22. Korea Food Industry Association. Household measures of commonly used food items, Seoul, 1998
  23. 통계청. 2003년 사회통계조사결과-보건, 사회참여, 소득과 소비, 2004
  24. Hong SM, Choi SY. A Study on meal management and nutrient intake of the elderly. J Korean Soc Food Sci Nutr 25(6): 1055- 1061, 1996
  25. Kim CI, Park YS. Comparing health-related behaviors, food behaviors, and the nutrient adequacy ratio of rural elderly by singleelderly families vs. extended families. Korean J Community Nutrition 5(2): 307-315, 2000
  26. Report on 2001 national health and nutrition survey - health behavior. Ministry of health & welfare, 2002
  27. Linn BS, Linn MW. Objective and self-assessed health in the old and very old. Social Science & Medicine 14: 311-315, 1980
  28. Cockerham WX, Sharp K, Wilcox JA. Aging and perceived health status. J Gerontol 38: 349-355, 1983 https://doi.org/10.1093/geronj/38.3.349
  29. Demian J, Ruigomez A, Pastor V, Martin-Moreno JM. Determinants of self assessed health among Spanish older people living at home. J Epidemiological Community Health 53: 421-416, 1999
  30. Schroll M, Ferry M, Lund-Larsen K, Enzi G. Assessment of health: self-perceived health, chronic diseases, use of medicine. Euronut SENECA investigators. Eur J Clin Nutr 45(Supple. 3): 169-182, 1991
  31. Stump TE, Clark Do, Johnson RJ, Wolinsky FD. The structure of health status among Hispanic, African American, and white older adults. J Gerontol B Psychol Sci Soc Sci 52: 49-60, 1997
  32. Lindgren AM, Svatdsudd K, Tibblin G. Factors related to perceived health among elderly people: the Albertina project. Age Ageing 23: 328-333, 1994 https://doi.org/10.1093/ageing/23.4.328
  33. Markides Ks, Lee DJ. Predictors of well-being and functioning in older Mexican Americans and Anglos: an eight-year followup. J Gerontol B Psychol Sci Soc Sci 45: 69-73, 1990
  34. Pudaric S, Sundquist J, Johansson SE. Country of birth, instrumental activities of daily living, self-rated health and mortality: a Swedish population-based survey of people aged 55-74. Social Science & Medicine 56: 2493-2503, 2003 https://doi.org/10.1016/S0277-9536(02)00284-8
  35. Chappell NL, Badger M. Social isolation and well-being. J Gerontol 445: 169-176, 1989
  36. Choi YJ, Park YS, Kim C, Chan YK. Evaluation of functional ability and nutritional risk according to self-rated health (SRH) of the elderly in Seoul and Kyunggi-do. Korean J Nutrition 373: 223-235, 2004
  37. Okosun IS, Choi S, Matamoros T, Dever GE. Obesity is associated with reduced self-rated general health status: evidence from a representative sample of white, black, and Hispanic Americans. Prev Med 32(5: 429-436, 2001 https://doi.org/10.1006/pmed.2001.0840
  38. Dhillon V, Hurst N, Hannan J, Nuki G. Association of low general health status, measured prospectively by Euroqol EQ5D, with osteoporosis, independent of a history of prior fracture. Osteoporos Int 16(5): 483-489, 2005 https://doi.org/10.1007/s00198-004-1705-3
  39. Kempen GIJM, Miedema I, Van den Bos GAM, Ormel J. Relationship of domain-specific measures of health to perceived overall health among older subjects. J Clin Epidemiol 51: 11-18, 1998 https://doi.org/10.1016/S0895-4356(97)00234-5
  40. Benyamini Y, Leventhal EA, Leventhal H. Elderly people's ratings of the importance of health-related factors to their selfassessments of health. Social Science & Medicine 56: 1661-1667, 2003 https://doi.org/10.1016/S0277-9536(02)00175-2
  41. Bryant LL, Beck A, Fairclough DL. Factors that contribute to positive perceived health in an older population. J Aging Health 12(2): 169-192, 2000 https://doi.org/10.1177/089826430001200202
  42. Miller MD, Schulz R, Paradis C, Houck PR, Mazumdar S, Frank E, Dew MA, Reynolds CF 3rd. Changes in perceived health status of depressed elderly patients treated until remission. Am J Psychiatry 153(10): 1350-1352, 1996 https://doi.org/10.1176/ajp.153.10.1350
  43. Idler EL, Kasl SV. Self-ratings of health: Do they also predict change in functional ability. J Gerontol B Psychol Sci Soc Sci 50(6): 344-353, 1995
  44. Kim HJ, Hong YS. An effect of muscle strength training program on instrumental activities of daily living and quality of life in the elderly. J Korean Community Nursing 6(1): 55-73, 1995
  45. Centers for Disease Control and Prevention. Measuring healthy days: population assessment of health-related quality of life. CDC, Atlanta Georgia, 2000
  46. Ounpuu S, Chambers LW, Patterson C, Chan D, Yusuf S. Validity of the US Behavioral Risk Factor Surveillance System's Health Related Quality of Life Survey Tool in a Group of Older Canadians. Chronic Dis Can 22(3-4): 93-101, 2001
  47. Al-Windi A. The relations between symptoms, somatic and psychiatric conditions, life satisfaction and perceived health. A primary care based study. Health Qual Life Outcomes 3: 28, 2005 https://doi.org/10.1186/1477-7525-3-3
  48. Gronbaek M, Mortensen EL, Mygind K, Andersen AT, Becker U, Gluud C, Sorensen TI. Beer, wine, spirits and subjective health. J Epidemiol Community Health 53(11): 721-724, 1999 https://doi.org/10.1136/jech.53.11.721
  49. Guallar-Castillon P, Rodriguez-Artalejo F, Diez Ganan LD, Banegas Banegas JR, Lafuente Urdinguio PL, Herruzo Cabrera RH.. Consumption of alcoholic beverages and subjective health in Spain. J Epidemiol Community Health 55(9): 648-652, 2001 https://doi.org/10.1136/jech.55.9.648
  50. Johansson SE, Sundquist J. Change in lifestyle factors and their influence on health status and all-cause mortality. Int J Epidemiol 28: 1073-1080, 1999 https://doi.org/10.1093/ije/28.6.1073
  51. Lee KH, Park MY. Nutrient intake of the rural elderly living in Kyungnam -focusing on health and aging status, and life-satisfaction. Korean J Community Nutrition 6(5): 773-788, 2001
  52. Manderbacka K, Lundberg L, Martikainen P. Do risk factors and health behaviors contribute to self-ratings of health?. Social Science & Medicine 48(12): 1713-1720, 1999 https://doi.org/10.1016/S0277-9536(99)00068-4
  53. Osler M, Heitmann BL, Hoidrup S, Jorgensen LM, Schroll M. Food intake patterns, self rated health and mortality in Danish men and women. A prospective observational study. J Epidemiol. Community Health 55: 399-403, 2001 https://doi.org/10.1136/jech.55.6.399
  54. Margetts BM, Thompson RL, Elia M, Jackson AA. Prevalence of risk of undernutrition is associated with poor health status in older people in the UK. Eur J Clin Nutr 57(1): 69-74, 2003 https://doi.org/10.1038/sj.ejcn.1601499