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Correlations between Cognitive Function and Occupational Participation in Dementia Patients

치매 환자의 인지 기능과 작업 참여와의 상관관계

  • Lee, Hyun-Jin (Department of Occupational Therapy, Kyungwoon University) ;
  • Kwon, Hyuk-Cheol (Department of Occupational Therapy, Daegu University) ;
  • Kim, Hwan (Department of Occupational Therapy, Daegu University)
  • 이현진 (경운대학교 작업치료학과) ;
  • 권혁철 (대구대학교 작업치료학과) ;
  • 김환 (대구대학교 작업치료학과)
  • Received : 2018.02.07
  • Accepted : 2018.04.06
  • Published : 2018.04.30

Abstract

This study was conducted to examine cognitive function and the ability for occupational participation in patients with mild and moderate dementia and to identify correlations between these two variables. The study investigated 95 dementia patients who visited a day care center in Daegu between September and November, 2017. Their detailed cognitive functions were examined using the Mini-Mental State Examination-Korean (MMSE-K) and the Korean Version of the Loewenstein Occupational Therapy Cognitive Assessment Geriatric population: LOTCA-G. Their occupational participation was measured using the Model of Human Occupation Screening Tool (MOHOST). The subjects' cognitive functions and abilities for occupational participation were analyzed using the descriptive statistics produced by the SPSS 20.0 program. In addition, Pearson correlation coefficient was used to analyze the correlations between the cognitive functions of the subjects and their abilities for occupational participation. The results of the study showed positive correlations between cognitive function and the ability for occupational participation of patients with mild and moderate dementia. Based on the results of this study, the evaluation of the patients with dementia and ability for occupational participation related to the cognitive function in establishing the therapeutic goal should be considered.

본 연구는 경도와 중등도 치매 환자의 인지 기능과 작업 참여 능력을 알아보고, 인지 기능과 작업 참여의 상관관계를 알아보고자 시행하였다. 2017년 9월부터 2017년 11월까지 대구광역시 지역의 주간보호센터를 방문하는 95명의 치매 환자를 대상으로 하였다. 인지 기능을 측정하기 위하여 한국판 간이정신상태 판별검사(MMSE-K)와 한국판 로웬스타인 작업치료 인지 평가-노인용(Loewenstein Occupational Therapy Cognitive Assessment Geriatric population: (LOTCA-G)을 사용, 작업 참여를 측정하기 위하여 인간작업모델 선별 평가도구(MOHOST)를 사용하였다. 본 연구 결과는 SPSS 20.0 통계처리 프로그램의 기술 통계를 이용하여 연구 대상자의 인지 기능과 작업 참여 정도를 분석하였고, 인지 기능과 작업 참여 간 상관관계 분석을 위해 피어슨 상관분석을 실시하였다. 연구 결과 치매 환자의 인지 기능과 작업 참여 간 상관관계를 확인할 수 있었다. 본 연구의 결과를 바탕으로 치매 환자의 평가 및 치료적 목표 수립 시 인지 기능과 관련한 작업 참여도 고려해야 할 것으로 사료된다.

Keywords

References

  1. J. A. Song, J. W. Park, H. J. Kim, "Impact of behavioral and psychological symptoms of dementia on caregiver burden in nursing homes," Journal of Korean Gerontological Nursing, vol. 15, no. 2, pp. 62-74, 2013
  2. M. Prince, R. Bryce, E. Albanese, A. Wimo, W. Ribeiro, CP. Ferri, "The global prevalence of dementia: A systematic review and meta analysis," Alzheimer's & Dementia, vol. 9, no. 1, pp. 63-75, 2013. DOI: https://doi.org/10.1016/j.jalz.2012.11.007
  3. G. U. Kim, H. N. Kim, H. Y. An, Y. J. Kim, J. E. Hwang, B. N. Kim, H. J. Nam, R. Y. Na, E. J. Byeon. Korean Dementia Observatory 2016. p.7-8, National Institute of Dementia, 2016.
  4. Y. J. Hwang, M. J. Jeong, K. S. Lee, H. K. Lim, D. J. Kim, "Effects of Tailored occupational activity program applied to patients with dementia in some community," Journal of the Korea Gerontological Society, vol. 31, no. 1, pp. 129-141, 2011.
  5. S. H. Park, J. Y. Yoo, S. J. Park, Y. A. Yang, "A systematic review about evaluating screening instruments of dementia patients of cognitive," Journal of Society of Occupational Therapy for the Aged and Dementia, vol. 3, no. 2, pp. 73-82, 2009.
  6. K. Y. Chang, J. Y. Kim, "Study of cognitive function for elderlies in urban area(using the Loewenstein Occupational Therapy Cognitive Assessment-Geriatric Poulation," Journal of Korean Society of Occupational Therapy, vol. 14, no. 3, pp. 71-83, 2006.
  7. N. Katz, B. Elazer, M. Itzkovich, "Construct validity of a geriatric version of the Lowenstein Occupational Therapy in Geriatric," Physical & Occupational Therapy in Geriatrics, vol. 13, pp. 31-46, 1995. DOI: https://doi.org/10.1080/J148v13n03_03
  8. N. Katz, D. Champagne, S. Cermak, "Comparison of the performance of younger and older adults in three version of a puzzle reduction test," American Journal of Occupational Therapy, Vol 51, pp. 184-192, 1997. DOI: https://doi.org/10.5014/ajot.51.7.562
  9. S. H. Kim, J. H. Jung, "The Correlation between Cognitive Function and Basic Activities of Daily Living of the Elderly People with Dementia in the Residential Care Facilities," Journal of Society of Occupational Therapy for the Aged and Dementia, vol. 7, no. 1, pp. 57-67, 2013.
  10. Y. Jeon, S. H. Shin, H. N. Kim, "A Systematic Review about Cognition Program of Dementia," Journal of Society of Occupational Therapy for the Aged and Dementia, vol. 11, no. 1, pp. 1-8, 2017.
  11. B. H. Lee, J. S. Park, N. R. Kim. "The effect of physical program on cognitive function, physical performance, gait, quality of life and depression in the elderly with dementia," Journal of Special Education & Rehabilitation Science, vol. 50, no. 2, pp. 307-328, 2011.
  12. Y. N. Lee, M. Y. Jung. "Clinical application of Model of Human Occupation on goal setting of elderly person with dementia: a case study," Therapeutic Science for Neurorehabilitation, vol. 2, no. 1, 2013.
  13. American Occupational Therapy Association(AOTA). "Occupational Therapy Practice Framework: Domain & Process 3rd edition," The American Journal of Occupational Therapy, vol. 68. Supplement.1, pp. S1-S48, 2014. DOI: https://doi.org/10.5014/ajot.2014.682006
  14. R. Taylor, A model of human occupation: Theory and application, 5th ed. p.329-348, Baltimore: Lippincott, Williams & Wilkins, 2017.
  15. H. Notoh, T. Yamada, N. Kobayashi, Y. Ishii, K. Forsyth, "Examining the structural aspect of the construct validity of the Japanese version of the Model of Human Occupation Screening Tool," British Journal of Occupational Therapy, vol. 77, no. 10, pp. 516-525, 2014. DOI: https://doi.org/10.4276/030802214X14122630932476
  16. S. Smallfield, C. Heckenlaible, "Effectiveness of Occupational Therapy Interventions to Enhance Occupational Performance for Adults With Alzheimer's Disease and Related Major Neurocognitive, Disorders: A Systematic Review," The American Journal of Occupational Therapy, vol. 71, no. 5, pp. 1-9, 2017. DOI: https://doi.org/10.5014/ajot.2017.024752
  17. A. Thinnes, R. Padilla, "Effect of Educational and Supportive Strategies on the Ability of Caregivers of People With Dementia to Maintain Participation in That Role," The American Journal of Occupational Therapy, vol. 65, no. 5, pp. 541-549, 2011. DOI: https://doi.org/10.5014/ajot.2011.002634
  18. K. Y. Lim, M. Y. Jung, "Clinical Application of Model of Human Occupation for Fragile Older Adult - A Case Study," Journal of Society of Occupational Therapy for the Aged and Dementia, vol. 7, no. 1, pp. 23-33, 2013.
  19. S. Parkinson, K. Forsyth, G. Kielhofner, The Model of Human Occupation Screening Tool(Version 2.0). Chicago, IL:Model of Human Occupation Clearinghouse, Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 2006.
  20. M. F. Folstein, S. E. Folstein, P. R. McHugh, "Mini-Mental state : A practical method for grading the cognitive state patients for the clinician," Journal of Psychiatric Research, vol. 12, pp. 189-198, 1975. DOI: https://doi.org/10.1016/0022-3956(75)90026-6
  21. Y. C. Kwon, J. H. Park, "Korean version of Mini-Mental State Examination(MMSE-K) Part I : Development of the Test for the elderly. Journal Of the Korean Neuropsychiatric Association, vol. 28, no. 1, pp. 125-135, 1989
  22. J. C. Morrian, "The clinical dementia rating: current version and scoring rules," Neurology, vol. 43, pp. 2412-2414, 1993. DOI: https://doi.org/10.1212/WNL.43.11.2412-a
  23. Y. J. Cha. T, Y, Lee, "Validity and reliability of modified LOTCA-G to reflect Korean cultural context," The Journal of Korean Society of Occupational Therapy, vol. 16, no. 2, 35-45, 2008.
  24. G. Kielhofner, C. W. Fan, M, Morely, M. Garnham, D. Heasman, K. Forsyth, S. W. Lee, R. R. Taylor, "A psychometric study of the Model of Human Occupation Screening Tool(MOHOST)," Hong Kong Journal of Occupational Therapy, vol. 20, no. 2, pp. 63-70, 2010. DOI: https://doi.org/10.1016/S1569-1861(11)70005-5
  25. AB-H. Erez, N. Katz, "Cognitive Profiles of Individuals with Dementia and Healthy Elderly: The Loewenstein Occupational Therapy Cognitive Assessment(LOTCA-G)," Physical & Occupational Therapy in Geriatrics, vol. 22, no. 2, pp. 29-42, 2003. DOI: https://doi.org/10.1080/J148v22n02_03
  26. S. H. Park, H. Y. Kim, "The effect of Client-Centered Cognitive Stimulation Therapy on The progression of Mild and Moderate dementia," Korean Journal of Care Management, vol. 17, pp. 81-96, 2015.
  27. Y. J. Lee, J. H. Lee, Y. J. Kim, N. Y. Yang, J. H. Park, "The Effect of Multimodal Intervention on Quality of Life, Depression, and Cognitive Function in Elderly People With Dementia: A Pilot Study," The Journal of Korean Society of Occupational Therapy., vol. 22, no. 3, pp. 85-97. 2014. DOI: https://doi.org/10.14519/jksot.2014.22.3.07
  28. H. J. Lee, "The Effects of Individualized Cognitive Program on LOTCA-G and ADL in Elderly with Dementia and Mild Cognitive Impairment," Journal of The Korean Society of Integrative Medicine, vol. 4, no. 1, pp. 21-29, 2016. DOI: https://doi.org/10.15268/ksim.2016.4.1.021
  29. J. S. Jang, "Comparison of Activities of Daily Living Differences with Dementia Stage," Journal of the Korea Academia-Industrial cooperation Society, vol. 18, no. 12, pp. 557-563, 2017. DOI: https://doi.org/10.5762/KAIS.2017.18.12.557
  30. J. S. Choi, E. Y. Yoo, B. I Chung, Y. M. Lim, "Cognitive Factors Affecting Self-Care in Dementia Elderly," Journal of the Korea Gerontological Society., vol. 23, no. 4. 113-126, 2003. DOI: https://doi.org/10.1590/S0080-62342010000400011
  31. LF. Talmelli, AC. Gratao, L. Kusumota, RA. Rodrigues, "Functional independence level and cognitive deficit in elderly individuals with Alzheimer's disease," Rev Esc Enferm USP, vol. 44, pp. 933-939, 2010. https://doi.org/10.1590/S0080-62342010000400011
  32. M. A. Trahan, J. Kuo, M. C. Carlson, L. Gitlin, "A systematic review of strategies to foster activity engagement in persons with dementia," Health Education and Behavior, vol. 41, Supply.1, pp. 70S-83S, 2014. https://doi.org/10.1177/1090198114531782
  33. C. D. Lee, M. Y. Jung, J. N. Kim, Y. J. Lee, "Effects of Client-Centered Home Modification and Caregiver Education on Activity Performance and Satisfaction of Persons With Mild Dementia : A Case Study," The Journal of Korean Society of Occupational Therapy., vol. 24, no. 1, pp. 75-88. 2016. DOI: https://doi.org/10.14519/jksot.2016.24.1.07
  34. A.W. Pan, C.W. Fan, L.I. Chung, T.J Chen, G. Kielhofner, M.Y. Wu, Y.L. Chen, "Examining the validity of the Model of Human Occupation Screening Tool: using classical test theory and item response theory," British Journal of Occupational Therapy, vol. 74, no. 1, pp. 34-40, 2011. DOI: https://doi.org/10.4276/030802211X12947686093648
  35. S. H. Ryu, The Effect of Virtual-Reality Program on Depression and Motivation for Rehabilitation and Occupational Participation for Stroke Patient, Unpublished Master's Thesis, Daegu University, Gyeongsan, 2015.
  36. H. R. Sim, Effects of Time-Use Intervention on Self-Efficacy and the Six Factors Influencing Occupational Participation for Stroke Survivors, Unpublished Master's Thesis, Daegu University, Gyeongsan, 2017.
  37. Byeon. Korean Dementia Observatory 2016. p.7-8, National Institute of Dementia, 2016.