Socio-Demographic Factors Affecting the Elderly's Preference for Life-Sustaining Treatment: Based on the 2017 National Survey of Older Koreans

Background: The Act on Decisions on Life-Sustaining Treatment (LST) for patients in hospice and palliative care or at the end of life was legislated in 2016 in Korea. This study aimed to identify factors that affect disagreement with LST in Koreans aged 65 years or older. Methods: This study was a cross-sectional design based on data from the 2017 National Survey of Older Persons. This study included 9,699 old individuals (3,856 males and 5,843 females). Multiple logistic regression analyses were conducted to investigate which factors were associated with LST disagreement. LST disagreement was defined as “strongly disagree” with LST according to a self-reported questionnaire. Results: In, total, 42.9% of males and 42.5% of females strongly disagreed with LST. Odds ratios (ORs) (confidence intervals [CIs]) of females with mild cognitive impairment or dementia for LST disagreement were 0.729 (0.632-0.841) and 0.707 (0.586-0.853), respectively, compared with those with normal cognition. Compared with a long education period (≥12 years), the OR (95% CIs) of an intermediate education period (6-11 years) was 0.837 (0.713-0.981) in females. Female private insurance holders were more likely to disagree with LST (1.151 [1.006-1.316]), while female regular exercisers were less likely to do so (0.817 [0.731-0.913]). However, males living with others besides spouse were less likely to disagree with LST compared with males living alone (0.757 [0.603-0.949]). Conclusion: Cognitive status, education, private insurance subscription, and regular exercise were significantly associated with LST disagreement in females, while only household structure was associated with it in males.