Korean Journal of Family Medicine

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"Seo Eun Hwang"

Original Articles

Association between mild depressive symptoms and annual changes in bone mineral density among South Korean women: a retrospective study: Jiyoung Baek, Hyemin Kim, Seo Eun Hwang, Kyungha Min; Received October 29, 2025 Accepted February 20, 2026 Published online June 16, 2026; DOI: https://doi.org/10.4082/kjfm.25.0313 [Epub ahead of print]

Background
Depression is associated with various physical conditions, including bone metabolism. Most previous studies were cross-sectional, and longitudinal findings regarding osteoporosis or fracture risk remain inconsistent. This study examined the association between mild depressive symptoms and annual changes in bone mineral density (BMD) among women undergoing repeated dual-energy X-ray absorptiometry (DEXA).
Methods
We retrospectively analyzed 1,629 women aged ≥20 years who completed the Patient Health Questionnaire-9 (PHQ-9) and underwent at least two DEXA scans between 2017 and 2023. Mild depressive symptoms were defined as PHQ-9 scores of 5–9. Annualized BMD changes at the lumbar spine, femoral neck, and total femur were calculated. Multivariable linear regression analyses adjusted for age, body mass index, smoking, alcohol consumption, physical activity, and diabetes. Women with PHQ-9 ≥10, only one DEXA scan, T-score ≤–2.5, or missing PHQ-9 data were excluded.
Results
Mild depressive symptoms were not significantly associated with annualized BMD change in the overall cohort. However, among women aged ≥60 years (n=1,047), PHQ-9 scores of 5–9 were associated with more negative annualized BMD changes at the femoral neck (β=–3.26; 95% confidence interval [CI], –5.92 to –0.61; P=0.016) and total femur (β=–2.24; 95% CI, –4.39 to –0.09; P=0.041), but not at the lumbar spine.
Conclusion
In women aged ≥60 years, mild depressive symptoms were negatively associated with annual BMD change. Given the close relationship between femoral BMD and hip fracture, even modest negative shifts may be clinically meaningful in older women.

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Association between Living Arrangements and Influenza Vaccination Rates among Elderly South Korean People: The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-2): Hye Min Cho, Joo-Yeon Kim, Seo Eun Hwang, Jae Chul Kim, Moo-Young Kim, Soo Hyoung Lee; Korean J Fam Med 2015;36(4):186-190. Published online July 17, 2015; DOI: https://doi.org/10.4082/kjfm.2015.36.4.186

Abstract
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Background

This study aimed to investigate the association between living arrangements and influenza vaccination among elderly South Korean subjects.

Methods

We used data from the fifth Korean National Health and Nutrition Examination Survey. Participants older than 65 years were included and categorized into 4 groups according to the type of living arrangement as follows: (1) living alone group; (2) living with a spouse group; (3) living with offspring (without spouse) group; and (4) living with other family members group. A total of 1,435 participants were included in this cross-sectional analysis.

Results

A lower vaccination rate was observed in the living with offspring (without spouse) group, whereas the living with a spouse group had higher rates of both seasonal and H1N1 influenza vaccination. After adjusting for age, sex, region, education level, income level, and number of comorbidities, the living with offspring (without spouse) group had a higher H1N1 vaccination non-receipt rate than the living alone group (odds ratio, 2.03; 95% confidence interval, 1.08-3.82).

Conclusion

Influenza vaccination rates differed according to the type of living arrangement. Particularly, those living with offspring (without spouse) had the lowest H1N1 influenza vaccination rate compared to those with other living arrangements, and this difference was significant. Interventions to improve influenza vaccination coverage should target not only elderly persons who live alone, but also those living with offspring.

Citations

Citations to this article as recorded by

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Jiayue Guo, Xitong Jiao, Shuai Yuan, Lili You
Vaccines.2025; 13(11): 1171. CrossRef
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Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
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Korean Journal of Family Medicine.2018; 39(2): 90. CrossRef
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Kyeong Hyang Byeon, Jaiyong Kim, Boyoung Choi, Bo Youl Choi
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Influenza Vaccination Status in Korean Adult Population in Relation with Socioeconomic and Medical Factors
Gyeong-Ran Byeon, Yang-Im Hur, Jae-Heon Kang, Hyun-Ah Park, Kyoung-Woo Kim, Young-Gyu Cho, Koh-Eun Shin, Bong-Hee Kang
Korean Journal of Health Promotion.2016; 16(1): 20. CrossRef