搜索结果：Journal of preventive medicine and public health = Yebang Uihakhoe chi

Chatbot technology improves access to and engagement with diabetes education. However, few studies have evaluated the feasibility and rigorously assessed the impact of chatbots among individuals with type 2 diabetes (T2DM) using theory-based approaches. This pilot study assessed the feasibility and preliminary impact of a chatbot on glycemic targets, loneliness, and perceived health beliefs among adults with T2DM. An explanatory mixed-methods approach, comprising a one-group experimental design and qualitative interviews, was used. The chatbot simulation, named "TakonGendhis," was developed based on conceptual models derived from the technology acceptance model and the health belief model. Feasibility included usefulness, ease of use, and intention to use. Preliminary impact was evaluated based on changes in glycemic targets, loneliness, and health beliefs from baseline to 12 weeks post-intervention. Qualitative data were gathered through individual interviews and focus group discussions and were analyzed thematically. Narrative synthesis was employed to integrate findings from the quantitative and qualitative phases of the study. The scores for usefulness, ease of use, and intention to use were 26.55, 27.32, and 34.03, respectively. Quantitative analysis revealed reduced loneliness, improved health beliefs, and lower glycemic scores after the 12-week intervention. The qualitative study identified 4 themes: feasibility, beliefs, emotional support, and areas for improvement. The intervention was feasible and had beneficial preliminary impacts on glycemic targets, loneliness, and health beliefs. Addressing feasibility, beliefs, emotional support, and identified areas for improvement may increase patients' willingness to use the chatbot.

Health-promoting behaviors are essential for maintaining independence and enhancing quality of life in aging populations. This study aimed to investigate the relationship between social support and health-promoting behaviors among older adults in Fasa, Iran in 2020. A cross-sectional study was conducted involving 300 older adults attending a specialized outpatient clinic in Fasa, Iran. Data were collected using a demographic questionnaire, the Walker Health-Promoting Lifestyle Profile, and the Canty Perceived Social Support Scale, administered either through self-report or structured interviews. Statistical analyses were performed using SPSS version 25 and included descriptive statistics, analysis of variance, the chi-square test, and multiple linear regression analyses. The mean age of participants was 68.9±7.8 years. Most participants were women (56.6%), married (81.7%), and had less than a high school education (41.3%). The mean scores for health-promoting behaviors and perceived social support were 124.2±31.3 and 24.4±9.4, respectively. A statistically significant positive association was observed between perceived social support and health-promoting behaviors (r=0.10, p=0.04). Social support, gender, and education level were identified as significant predictors of health-promoting behaviors, collectively explaining 34% of the variance. These findings emphasize the pivotal role of social support in promoting health-related behaviors among older adults. Interventions that strengthen social support networks, foster enabling environments, and address gender and educational disparities are recommended to improve health outcomes and quality of life in aging populations. Policymakers and healthcare planners should incorporate these determinants into the design of targeted, evidence-based interventions for older adults.

Fine particulate matter (PM2.5; aerodynamic diameter ≤2.5 µm) is a leading contributor to the global burden of disease and is associated with substantial morbidity and mortality. However, its health effects are often evaluated within single-exposure frameworks, limiting causal inference and reducing the translational relevance of evidence for policy development. In this study, we reconceptualise PM2.5 within the exposome framework by integrating external exposures, internal biological responses, and structural determinants of health across the life course. PM2.5 comprises a complex and dynamic mixture of pollutants from ambient and household sources, including biomass combustion, traffic emissions, and industrial activities. After inhalation, PM2.5 particles can penetrate the respiratory tract, and finer fractions may enter the systemic circulation, where they induce oxidative stress, inflammation, epigenetic dysregulation, and endocrine disruption. These mechanisms contribute to a broad spectrum of adverse health outcomes, including cardiovascular, respiratory, metabolic, and neurodegenerative diseases as well as cancers. The multi-level and temporally accumulated nature of these effects highlights the limitations of reductionist exposure assessment and underscores the need for integrative, systems-based approaches. Integrating cumulative impact assessment with exposome-wide approaches that leverage satellite, clinical, land-use, urban planning, and socioeconomic data can improve the characterisation of context-specific cumulative health effects. Positioning PM2.5 as a sentinel indicator of cumulative environmental risk provides a unifying framework for exposome-informed science and supports the development of more precise, equitable, and policy-relevant interventions.

The objective of this study was to develop machine learning models to predict health insurance claim costs among older adults in Indonesia. This study utilized secondary data from the Indonesian National Health Insurance program (Jaminan Kesehatan Nasional [JKN]) spanning 2017 to 2023. Three modeling techniques-linear regression, random forest, and XGBoost-were employed to predict individual claim costs. Model performance was assessed using the root mean square error (RMSE), coefficient of determination (R2), and mean absolute error (MAE). Additionally, variable importance analysis was conducted to identify key predictors. XGBoost with 500 boosting rounds yielded the best performance, with an RMSE of 11 360 283, an R2 of 0.81, and an MAE of 4 485 917, outperforming both linear regression (RMSE, 13 710 035; R2=0.72) and random forest (RMSE, 12 434 238; R2=0.78). Notably, outpatient care was identified as the most consistent predictor across all models. Other significant predictors included length of stay (LOS), diagnosis type (International Classification of Diseases, 10th revision chapter), facility type, facility classification, and severity of illness, particularly for moderate cases. Although LOS and diagnosis type were important predictors, these findings should be interpreted in the context of Indonesia's fixed Indonesian Case-Based Groups payment system. XGBoost provides reliable predictions of claim costs among older adults, capturing clinical, utilization, and structural drivers. These findings can inform targeted interventions, improve chronic disease management, optimize the referral system, and support integration of predictive tools into JKN to enhance responsiveness and promote sustainable, equitable financing.

Occupational noise exposure is a widespread hazard across multiple industries. However, the association between occupational noise exposure and cardiovascular health outcomes remains inconclusive. This study aimed to compare cardiovascular function between workers exposed and unexposed to occupational noise and to compare lipid profiles between these groups. An ex-post-facto (comparative cross-sectional) study was conducted in a denim garment manufacturing facility in Ismailia, Egypt. Two equal groups of workers exposed to occupational noise (&#x2265;85 dB[A] for &#x2265;3 years, n=213) and unexposed workers (<85 dB[A], n=213) were recruited using systematic sampling, but three unexposed workers dropped out. Data collection included structured interviews, clinical examinations, 12-lead electrocardiography (ECG), blood pressure measurements, and laboratory lipid profile analyses. Noise exposure was assessed using both environmental and personal integrated sound level meters. Multiple logistic regression analysis was performed to identify potential predictors of ECG abnormalities. The mean ages of the noise-exposed and unexposed groups were 34.5&#xb1;9.8 and 33.3&#xb1;7.7 years, respectively, and females accounted for 67.6% and 66.2% of the groups, respectively. Noise-exposed workers had significantly higher pulse pressure, systolic blood pressure, low-density lipoprotein cholesterol (LDL-C), total cholesterol, triglyceride levels, and prevalence of dyslipidemia (59.2% vs. 48.6%, p<0.05). ECG abnormalities were more prevalent in the noise-exposed group than in the unexposed group (30% vs. 8%, p<0.001), with P mitrale and right bundle branch block being the most frequent findings. Duration of noise exposure, personal noise level, age, and systolic blood pressure were independent predictors of ECG abnormalities. Body mass index (BMI) and duration of noise exposure were significant predictors of dyslipidemia. Chronic occupational noise exposure was associated with elevated blood pressure, dyslipidemia, and ECG abnormalities. Longer duration and higher intensity of noise exposure were also associated with increased cardiovascular risk indicators. These findings support workplace noise-control measures, periodic cardiovascular screening, and improved use of personal protective equipment in similar garment manufacturing settings.

Health literacy (HL) is a key determinant of health behaviors and health outcomes. However, the lack of validated Hindi-language instruments limits its assessment in India. This study aimed to translate, culturally adapt, and psychometrically validate 3 internationally recognized tools-the Short Assessment of Health Literacy in English (SAHL-E), the All Aspects of Health Literacy Scale (AAHLS), and the European Health Literacy Survey Questionnaire (HLS-EU-Q47)-for Hindi-speaking adults in rural North India. A community-based cross-sectional study enrolled 250 adults from 5 villages in Uttar Pradesh. Translation followed forward-backward procedures with expert review and pretesting. Psychometric evaluation included internal consistency (Cronbach &#x3b1;), test-retest reliability (intraclass correlation coefficients, ICC), construct validity (exploratory factor analysis), convergent and known-groups validity, and feasibility indicators (completion rates and interview duration). All instruments demonstrated strong psychometric performance. Cronbach &#x3b1; values were 0.84 (SAHL-E), 0.87 (AAHLS), and 0.93 (HLS-EU-Q47), and ICCs ranged from 0.86 to 0.94. Factor structures aligned with theoretical expectations. Convergent correlations ranged from 0.42 to 0.61 (p<0.001), and known-groups validity analyses showed significant differences according to education and occupation. Completion rates exceeded 98%, and the mean interview duration was approximately 32 minutes. The Hindi-adapted SAHL-E, AAHLS, and HLS-EU-Q47 demonstrated strong reliability, validity, and feasibility for assessing HL among rural adults in India.

This study aimed to develop and test a comprehensive model analyzing direct and indirect relationships among workload, demographic factors, fatigue, work stress, and quality of life among aircraft maintenance personnel (AMP). This cross-sectional study was conducted at the maintenance, repair, and overhaul facility at Sultan Hasanuddin Airport, Makassar. Data collection combined structured interviews, standardized questionnaires (the NASA Task Load Index, Work Fatigue Feeling Measurement Questionnaire, Depression Anxiety Stress Scale-21, and World Health Organization Quality of Life-BREF), and objective measures (a Cocoro Meter for stress and an oximeter for physical workload). The model was examined using partial least squares structural equation modeling (PLS-SEM), which is well-suited to complex models with latent variables and non-normally distributed data. In the PLS-SEM analysis, physical workload (&#x3b2;=0.229, p=0.018) and work experience (&#x3b2;=0.277, p=0.007) were significantly and directly associated with fatigue. Age significantly predicted work stress (&#x3b2;=0.371, p=0.001). Crucially, fatigue (&#x3b2;=-0.344, p=0.002) and work stress (&#x3b2;=-0.385, p<0.001) had significant negative direct effects on quality of life and were central mediators. No direct effects of exogenous variables on quality of life were observed. Cross-tabulation supported these findings; subgroups with higher physical demands, longer tenure, and older age reported greater fatigue, higher stress, and lower quality of life. Fatigue and work stress are pivotal mediators that are significantly associated with reduced quality of life among AMP. Interventions to reduce physical workload and provide targeted support for more experienced and older workers may improve well-being and safety in the aviation maintenance industry.

Catastrophic health expenditures (CHE) is a well-established indicator of financial risk protection. This study aimed to examine the contribution of medication expenditure to CHE and the associated socioeconomic inequalities. Data were drawn from 6 nationally representative income and expenditure surveys covering the period 2019-2024. Using the budget share method, CHE was defined as out-of-pocket (OOP) health payments exceeding 25% of a household's total consumption expenditure. The contribution of medication expenditures to CHE was then calculated as the difference in the proportion of households experiencing CHE with and without medication payments. Socioeconomic inequalities were quantified using the Concentration Index (CI), and decomposition analysis was conducted to identify the primary drivers of overall socioeconomic inequality in the contribution of medication expenditures to CHE. During the study period, medications represented a substantial share of household health expenditures and contributed to CHE. In 2024, OOP spending on medications accounted for 31.2% of total health expenditures, while the contribution of medication expenditures to CHE was 1.28%. The CI indicated that the contribution of medication expenditures to CHE was concentrated among poorer households. Decomposition analysis further identified medium-sized households, male-headed households, households with employed heads, insured households, and urban households as the main contributors to this socioeconomic inequality. In Iran, OOP payments for medications constitute a substantial share of household healthcare expenditures and contribute to CHE. Because the roots of inequality extend beyond the healthcare system, addressing this issue requires a comprehensive, cross-sectoral strategy that integrates broader social and economic policies.

Indonesia has the second-highest number of tuberculosis (TB) cases globally, after India. The estimated TB incidence in Indonesia is 1 090 000 cases (387 cases per 100 000 population), with an associated mortality of 131 000 deaths (47 deaths per 100 000 population). The 2023-2024 TB Inventory Study in Indonesia aimed to quantify the extent of under-reporting by identifying TB cases that were diagnosed and/or treated but not reported to the National TB Surveillance System (Sistem Informasi Tuberkulosis [SITB]). This study specifically assessed the magnitude of under-reporting of TB cases among children younger than 15 years in Indonesia. This study used a cross-sectional design and analyzed data from the 2023-2024 TB Inventory Study (SIV-TB) in Indonesia. The sample included all TB cases in children younger than 15 years identified from eligible health facilities. Under-reported cases were defined as those that were diagnosed and/or treated but not reported to the SITB. Descriptive statistics were used to characterize under-reporting. A record-linkage process was performed to compare SIV-TB data with SITB data after deduplication. A total of 12 293 TB cases in children younger than 15 years were identified across health facilities in 31 districts and cities. The overall under-reporting rate for childhood TB was 23.5%. The highest under-reporting rate was observed in Eastern Indonesia (28.0%). Under-reporting of childhood TB was significantly associated with both age group and type of health facility.

To identify behavioral segments of integrative care use among older adults with knee osteoarthritis in a rural district in Northern Thailand and to compare these segments according to PRECEDE-related factors and baseline characteristics. This analytical cross-sectional study included 302 community-dwelling older adults with primary knee osteoarthritis in Thoen District, Lampang Province, Northern Thailand. Data were collected through face-to-face interviews using a structured questionnaire that assessed demographic and health characteristics, PRECEDE-related factors, and behaviors across 3 care domains: professional medical care, traditional medicine, and community-based medicine. Standardized behavioral domain scores were analyzed using hierarchical cluster analysis, followed by k-means clustering. Differences among segments were examined using chi-square tests, 1-way analysis of variance, or Kruskal-Wallis tests, as appropriate. Three behavioral segments were identified: high engagement (20.9%), intermediate engagement (48.0%), and low engagement (31.1%). The 3 behavioral domains differed significantly across segments (all p<0.001; &#x3b7;&#xb2;=0.400-0.535). Baseline demographic and health characteristics did not differ significantly among segments. In contrast, significant differences among segments were observed for the total enabling score, access, total reinforcing score, social support, and attitude, whereas perceived information showed no significant difference. Older adults with knee osteoarthritis were not behaviorally homogeneous in their use of professional, traditional, and community-based care. Segment differences were more pronounced for enabling and reinforcing conditions than for perceived information alone. These findings support segment-informed health promotion strategies in primary care and community settings.

Heart failure (HF), a common comorbidity of chronic obstructive pulmonary disease (COPD), is associated with an increased risk of death among patients with COPD. However, no systematic assessment has quantified the population-level burden of comorbid COPD and HF, hereafter referred to as COPD-HF comorbidity, worldwide. This study assessed the global, regional, and national burden of COPD-HF comorbidity from 1990 to 2021 and projected this burden to 2050. Data on the non-fatal burden of COPD-HF comorbidity, including prevalence and years lived with disability (YLDs), were obtained from the Global Burden of Disease Study 2021. Temporal trends in age-standardized rates (ASRs) for COPD-HF comorbidity from 1990 to 2021 were examined using joinpoint models. Bayesian age-period-cohort models were used to project ASRs to 2050. From 1990 to 2021, the absolute numbers of prevalent cases and YLDs for COPD-HF comorbidity increased globally, and the ASRs for prevalence and YLDs also increased. These upward trends were projected to continue to 2050. The burden of COPD-HF comorbidity was consistently higher in men than in women and higher in older adults than in younger individuals. By severity level, the burden of COPD-HF comorbidity was mainly attributable to the treated and severe subtypes of HF. The burden varied substantially across regions, with low-development regions having the highest age-standardized burden. The global non-fatal burden of COPD-HF comorbidity was substantial from 1990 to 2021 and may continue to increase to 2050. Public health interventions targeting COPD-HF comorbidity may help reduce this burden.

Studies of the associations between coronavirus disease 2019 (COVID-19) control measures and infant health in Vietnam are limited. This study investigated differences in birth outcomes between pregnancies during the COVID-19 pandemic and those before the pandemic. Data on infants born alive between 2016 and 2023 in Ho Chi Minh City (HCMC) were collected. For each infant, the estimated first day of pregnancy was calculated based on birth date and gestational age. Linear and logistic regression analyses were conducted to identify significant associations. The birth outcomes examined included decreased birth weight (BW), low birth weight (LBW), term LBW, and preterm birth (PTB). The models were adjusted for infant sex, birth order, gestational age, and maternal age. The COVID-19 pandemic period in HCMC was defined as April 2020 to December 2022. Among 172 017 infants, 31.4% had at least 1 trimester of gestation during the COVID-19 pandemic, 44.2% were first births, and 52.0% were male. Infants with full gestation during the pandemic had significantly lower BW (by 20.7 g) compared to those born pre-pandemic. Pregnancy during the COVID-19 pandemic was associated with higher rates of LBW, term LBW, and PTB compared to the pre-pandemic period. The odds ratios (95% confidence intervals) were 1.21 (1.15 to 1.27), 1.28 (1.18 to 1.39), and 1.10 (1.06 to 1.15), respectively. The COVID-19 pandemic was associated with elevated risk of adverse birth outcomes. Lessons learned from the COVID-19 response should be applied to prepare for future outbreaks.

Thailand is rapidly transitioning to an aged society. Lower limb muscle weakness among older adults is associated with increased fall risk, loss of independence, and reduced quality of life (QOL). Although exercise can improve strength and mobility, many community-dwelling older adults face barriers to participation. We evaluated the effectiveness of an innovative leg support ring for lower limb muscle rehabilitation among older adults in Eastern Thailand. This quasi-experimental, repeated-measures study included 64 adults aged 60 years or older with lower limb muscle weakness and activities of daily living (ADL) scores of 9-11. The intervention group (n=32) used the leg support ring for 12 weeks (3-5 days/week), while the control group (n=32) received standard care and continued usual physical exercise. Leg motor power, range of motion (ROM), ADL, and QOL were assessed at baseline, immediately post-intervention, and at the 3-month follow-up. Data were analyzed using repeated-measures analysis of variance. Compared with control participants, the intervention group showed significantly greater improvements in motor power of the quadriceps, hamstrings, hip flexors, ankle dorsiflexors, and ankle plantar flexors (p<0.001) and ROM for hip flexion, hip extension, knee flexion, and ankle plantarflexion (p<0.05). ADL and QOL also demonstrated significantly greater improvements (p<0.001). These improvements were sustained or further increased at the 3-month follow-up. The leg support ring program was associated with improvements in lower limb strength, mobility, functional independence, and QOL among older adults. Its simplicity and accessibility may support integration into community-based health promotion programs for active aging.

Karoshi, or "death from overwork," has been recognized for decades; however, epidemiological findings regarding long working hours (LWH) and ischemic heart disease (IHD) remain inconsistent. This study aimed to provide new evidence on the association between LWH and IHD, while accounting for job strain among Japanese workers, both male and female. This study utilized data from 6670 workers participating in the Jichi Medical School Cohort Study. Baseline working hours were categorized as <5.0, 5.0 to 6.9, 7.0 to 8.9 (reference), 9.0 to 10.9, and &#x2265;11.0 hr/day. Fatal and non-fatal incident IHD cases were determined during follow-up using International Classification of Diseases, 10th revision codes. Multivariable Cox proportional hazards models were used to examine associations, adjusting for socio-demographic factors, lifestyle behaviors, cardiometabolic characteristics, and job strain. During a mean follow-up of 12 years, 58 incident IHD cases (42 male and 16 female) were documented. Long working hours (&#x2265;11.0 hr/day) were significantly associated with an increased risk of IHD in the total sample (hazard ratio, 2.92; 95% confidence interval, 1.15 to 7.39), and the overall pattern of associations was similar in sex-stratified analyses. These findings suggest that LWH independently increases the risk of IHD among Japanese workers, even after adjustment for job strain, underscoring the importance of managing working hours to reduce karoshi in both male and female workers.

Assessing healthcare quality at the national level is essential for evaluating health system performance and identifying areas requiring improvement. This study examined long-term trends in healthcare quality in Korea from 2008 to 2023 using internationally comparable indicators. We conducted a trend analysis of healthcare quality in Korea using the Organization for Economic Cooperation and Development (OECD) Health Care Quality and Outcomes framework and quality indicators. Indicators across multiple domains, including acute care, primary care, prescribing in primary care, mental healthcare, and patient experiences, were analyzed and compared with OECD averages. Healthcare quality in Korea improved across several domains. Thirty-day mortality for acute myocardial infarction decreased from 14.2% in 2008 to 10.2% in 2023, while mortality for ischemic stroke declined from 8.7% to 5.5%. Avoidable hospitalizations decreased substantially, with hospitalizations for chronic obstructive pulmonary disease declining by 59.7%. The proportion of patients with diabetes receiving cholesterol-lowering treatment increased from 44.1% to 82.5%. However, the proportion of broad-spectrum antibiotic prescriptions remained substantially higher than the OECD average (40.3 vs. 15.5%). In mental healthcare, excess mortality ratios increased from 4.3 in 2010 to 4.9 in 2023 for schizophrenia and from 3.5 to 4.3 for bipolar disorder, while post-discharge suicide rates showed little improvement. Patient experience indicators related to patient-physician communication improved and approached OECD averages. Healthcare quality in Korea improved substantially between 2008 and 2023, particularly in acute care outcomes and chronic disease management. However, persistent challenges remain in areas such as antibiotic use, polypharmacy, and mental healthcare. These findings provide internationally comparable evidence to inform future health policy and healthcare quality improvement efforts.

This study investigated how the mediating effect of health literacy (HL) on the association between income and cancer screening participation varies by age among Korean adults aged 40 years and older, with the aim of identifying the optimal timing for HL interventions. Data from 4171 adults aged &#x2265;40 years in the 2023 Korea National Health and Nutrition Examination Survey were analyzed using moderated mediation analysis implemented with the lavaan.survey package, accounting for the complex sampling design. The Johnson-Neyman technique was used to identify age thresholds at which the mediation effect became statistically significant, and the number needed to benefit (NNB) was calculated to estimate the potential efficiency of interventions targeting this pathway. Each 1-quintile increase in income was associated with a 16.0% higher likelihood of undergoing cancer screening (odds ratio=1.16, p<0.001). The mediating effect of HL increased significantly with age (index of moderated mediation=0.000438, p=0.048). Mediation became statistically significant from age 54.2 years (Johnson-Neyman threshold), with the proportion of the total effect mediated rising from 0.1% among adults aged 40-49 years to 8.1% among those aged &#x2265;70 years. The NNB for this pathway indicated substantial intervention efficiency in older adults (NNB=372 for ages &#x2265;70), whereas the mediation effect was not statistically significant in the 50-59 age group. HL significantly mediated the relationship between income and cancer screening participation from the mid-50s onward, with progressively greater contributions at older ages. These findings support age-differentiated strategies, including structural accessibility improvements for adults in their 40s and early 50s and integrated income-HL interventions for individuals aged &#x2265;55 years. Experimental studies are warranted to confirm these associations.

Child sexual abuse is the most frequently reported form of violence against children in Indonesia, with reported cases increasing over the past 5 years. This study aimed to identify risk and protective factors associated with sexual abuse among adolescents aged 13-17 years in Indonesia. The analysis used data from the 2024 National Survey of Children's and Adolescents' Life Experiences (SNPHAR), including 6811 respondents. Bivariate analyses were conducted using chi-square tests to identify variables associated with sexual abuse. Variables with p-values less than 0.25 in binary logistic regression were included in multivariable logistic regression. Odds ratios, adjusted odds ratios (aORs), and 95% confidence intervals (CIs) were calculated to identify risk and protective factors associated with the experience of sexual abuse. Overall, 8.7% of respondents reported experiencing sexual abuse. Protective factors included never having worked (aOR, 0.77; 95% CI, 0.61 to 0.99; p<0.05), never having witnessed violence (aOR, 0.20; 95% CI, 0.17 to 0.24; p<0.001), and no history of sexual intercourse (aOR, 0.08; 95% CI, 0.04 to 0.15; p<0.001). Conversely, positive gender attitudes (aOR, 1.56; 95% CI, 1.29 to 1.87; p<0.001) and knowledge of child protection services (aOR, 3.85; 95% CI, 3.15 to 4.72; p<0.001) were unexpectedly associated with elevated risk. Violence-free environments and limited exposure to early sexual experiences appear to represent critical protective factors. Counterintuitive associations suggest potential influences of cultural norms, patriarchy, and limited access to services.

Falls are a leading cause of morbidity and mortality among older adults, often resulting in severe injuries and a loss of independence. Dual-task training, which integrates cognitive and motor exercises, has emerged as a promising intervention for fall prevention. This study aimed to evaluate the effects of a structured cognitive and motor dual-task training program on fall risk, balance, and cognitive function in community-dwelling older adults. Seventy-two participants aged 60 years or older were randomly assigned to either an intervention group (IG, n=36) or a control group (CG, n=36). The IG underwent 3 sessions per week for 8 weeks (totaling 24 sessions) that incorporated simultaneous cognitive and motor exercises, while the CG continued their usual total body stretching exercise. Assessments were conducted at baseline, week 4, and week 8, and included gait speed (10-meter walk test), functional performance (Timed Up and Go test), cognitive function (Montreal Cognitive Assessment), and quality of life (World Health Organization Quality of Life Assessment). Participants in the IG demonstrated significant improvements in functional performance (p<0.05) and enhanced cognitive function compared to the CG after both 4 weeks and 8 weeks of training. Functional performance and cognitive function significantly improved after 8 weeks of training (p<0.01). However, the intervention did not produce changes in gait speed or quality of life. Integrating cognitive and motor dual-task training into fall prevention programs may enhance functional stability and cognitive resilience in older adults. Future studies should investigate long-term adherence and determine the optimal training intensity.

Korea is one of the fastest-aging societies, and a large proportion of its older population lives alone. This study examined the impact of family interaction frequency on the association between living alone and depressive symptoms among older adults aged &#x2265;80 years using nationally representative survey data. Among the 229 099 participants of the 2019 Korea Community Health Survey, 15 672 participants aged &#x2265;80 years who either lived with close family or lived alone were included in the analysis. Participants living alone were classified according to the frequency of family interaction, ranging from less than once a month to more than once a week. The outcome variable was moderate to severe depressive symptoms, defined as a Patient Health Questionnaire-9 score of &#x2265;10. The prevalence of depressive symptoms was higher among older adults living alone (9.4-14.1%, depending on the frequency of family interaction) than among those living with close family (6.5%). Older adults living alone who interacted with family less than once a month were more likely to report depressive symptoms compared with those living with close family (adjusted odds ratio [aOR], 1.71; 95% confidence interval [CI], 1.36 to 2.15). Weekly family interaction mitigated the impact of living alone on the prevalence of depressive symptoms (aOR 1.10; 95% CI, 0.84 to 1.42). The influence of family interaction on the association between living alone and depressive symptoms remained consistent across subgroups of men, women, and those with difficulty in daily activities. Encouraging regular interaction among family members could serve as an effective strategy to protect the mental health of older adults.