Environment-Stratified Age-Period-Cohort Effects on the Prevalence of Walking Among Older Adults

Socioeconomic, health, and social connectedness factors associated with self-rated health of octogenarians and nonagenarians in South Korea: urban and rural comparison

BACKGROUND

The aging population, including octogenarians (aged 80-89) and nonagenarians (aged 90-99), is rapidly increasing. Understanding their self-rated health in urban and rural settings is vital for public health policy development. This study examined factors associated with self-rated health among octogenarians and nonagenarians across urban and rural areas of South Korea.

METHODS

We analyzed data from 21,896 older adults (aged 80-99) from the 2023 Korea Community Health Survey. Self-rated health was assessed on a 5-point scale and categorized as "good" or "poor." Variables included age, residence area (urban/rural), sociodemographic characteristics, health behaviors, healthcare utilization, morbidity, and social interactions. Descriptive statistics were used to examine variable distributions, and logistic regression models identified factors associated with self-rated health in each age group and residential area.

RESULTS

Among octogenarians, 18.7% in urban areas reported good self-rated health, compared to 15.0% in rural areas. Conversely, a smaller proportion of nonagenarians in urban areas (13.6%) reported good self-rated health than those in rural areas (14.7%). Among octogenarians, having a high school education or higher was associated with better self-rated health compared to those with no formal education (urban OR = 1.67, 95% CI = 1.39-2.00; rural OR = 1.67, 95% CI = 1.30-2.14). Furthermore, a monthly household income of 3 million Korean Won (KRW) or more, compared to an income of less than 1 million KRW, was associated with better self-rated health among octogenarians (urban OR = 1.35, 95% CI = 1.09-1.66; rural OR = 1.54, 95% CI = 1.19-2.00). The associations between educational level and self-rated health were less pronounced among nonagenarians. Consistently across both age groups and settings, regular walking (OR range: 1.39 [95% CI = 1.21-1.60] for rural octogenarians to 2.17 [95% CI = 1.78-2.64] for urban nonagenarians), good self-rated oral health (OR range: 2.51 [95% CI = 1.96-3.22] for urban nonagenarians to 3.51 [95% CI = 3.01-4.09] for rural octogenarians), and participation in social activities (OR range: 1.23 [95% CI = 1.09-1.41] for urban octogenarians to 1.58 [95% CI = 1.20-2.07] for rural octogenarians) were positively associated with good self-rated health.

CONCLUSIONS

Characteristics associated with self-rated health differed significantly between octogenarians and nonagenarians in rural and urban areas. Public health strategies must support health-promoting behaviors such as regular walking, enhance oral health services, improve healthcare accessibility, reduce environmental stressors, and strengthen social support networks to promote health among octogenarians and nonagenarians.

An Investigation of the Sled-Push Exercise Using a Resisted Sled Machine in Apparently Healthy Older Adults: An Exploratory Study

Physical function is regarded as the cornerstone of healthy aging, and exercise is an important determinant of healthy aging. This study examined the feasibility and physiological (heart rate, blood pressure, blood lactate, and rate of perceived exertion) and psychological (enjoyment) response resulting from an acute progressive sled-push (SLP) exercise session using the novel XPO Sled Trainer in older adults and compared that with walking (WKC) condition. The exercise session comprised six exercise bouts at 75%, 85%, 100% (2×), and 125% (2×) of normal velocity with a 2-min rest between bouts. Thirty-six older adults were randomly allocated into either the SLP or WKC conditions. No adverse events were observed during the exercise session, and all participants completed the exercise protocol as prescribed. One-third of the participants in the SLP group reported minimal body discomfort. Significantly higher responses were observed for all physiological variables as the intensity of the exercise increased in the SLP group compared with the WKC group (p < .001). The SLP group presented a decline in enjoyment as the intensity of the exercise increased (during), but similar enjoyment level than the WKC group for the overall exercise session (p = .711). Our findings support the viability and safety of SLP exercise using the XPO Sled Trainer in older adults. Such exercise demonstrated an intensity-driven modality that may have potential to elucidate positive adaptations in the cardiovascular system of older adults with acceptable levels of enjoyment.