문화기술의 융합 (The Journal of the Convergence on Culture Technology)

  • 제8권5호
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  • Pages.71-80
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  • 2022
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  • 2384-0358(pISSN)
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  • 2384-0366(eISSN)
국제문화기술진흥원 (The International Promotion Agency of Culture Technology)
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DOI QR코드

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비약물 중재프로그램이 경도인지장애 노인의 우울 증상에 미치는 효과: 체계적 문헌고찰과 메타분석

Effects of non-pharmacological intervention on depressive symptoms in the older adults with mild cognitive impairment : A systematic review and meta-analysis

  • 방양희 (백석문화대학교 간호학과) ;
  • 조미정 (이화여자대학교 간호학과)
  • 투고 : 2022.07.06
  • 심사 : 2022.08.31
  • 발행 : 2022.09.30
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초록

본 연구는 국내·외 경도인지장애 노인에게 시행된 비약물 중재의 우울 증상에 대한 효과를 확인하기 위해 시행되었다. PubMed, CINAHL, PsycINFO, Science direct, KISS, RISS, DBPia 등의 전자 데이터베이스를 통해 총1,147편의 문헌을 검색하였고 문헌선정 기준을 충족하는 21편의 문헌이 선정되었다. 선정된 문헌의 질평가는 2명의연구자가 독립적으로 시행하였다. 비약물 중재의 효과크기는 CMA3.0 프로그램을 이용하여 분석하였고, 분석결과 비약물 중재의 우울 증상에 대한 전체 효과크기는 중간효과크기(ES=-0.68)로 나타났다. 하위그룹 분석결과, 인지중재(ES=-1.03)와 복합중재(ES=-0.97)가 운동중재(ES=-0.53)에 비해 큰 효과크기를 나타냈다. 본 연구결과 비약물 중재가 경도인지장애 노인의 우울 증상 감소에 효과적임이 확인되었으며, 이를 토대로 경도인지장애 노인의 인지기능과 우울 증상 개선을 위한 다양한 비약물 중재프로그램이 시행되기를 기대한다.

The purpose of this study was to evaluate the effects of the non-pharmacological intervention on depressive symptoms in the older adults with mild cognitive impairment. A total of 1,147 studies were retrieved from PubMed, CINAHL, PsycINFO, Science direct, KISS, RISS, and DBPia. Twenty-one studies which met the criteria were selected and the quality assessment was conducted independently by two investigators. The effect size of non-pharmacological intervention was estimated using Comprehensive Meta-Analysis 3.0. The overall effect size turned out to be the medium effect size (Hedges' g=-0.68, 95% CI=-1.01~-0.36). As a result of the subgroup analysis, the intervention type was statistically significant. The effect size of cognitive intervention (Hedges' g=-1.03, 95% CI=-1.43~-0.61) and multi component intervention (Hedges' g=-0.97, 95% CI=-1.63~-0.33) was greater than excise intervention (Hedges' g=-0.53, 95% CI=-1.16~0.03). This study shows that non-pharmacological intervention was also effective in reducing depressive symptoms in the older adults with mild cognitive impairment. Based on the research results, it is expected that various non-pharmacological intervention studies will be attempted to improve cognitive function and depressive symptoms of the older adults with mild cognitive impairment.

키워드

참고문헌

  1. R.C. Petersen, G.E. Smith, S.C. Waring, R.J. Ivnik, E.G. Tangalos, and E. Kokmen. "Mild cognitive impairment:clinical characterization and outcome," Archives of Neurology, Vol. 56, No. 3, pp. 303-308, 1999. https://doi.org/10.1001/archneur.56.3.303
  2. National Institute of Dementia. Korean Dementia observatory 2019. https://www.nid.or.kr/info/dataroom_view.aspx?bid=209
  3. R.C. Petersen, R. Doody, A. Kurz, R.C. Mohs, J.C. Morris, P.V. Rabins, et al. "Current concepts in mild cognitive impairment," Archives of Neurology, Vol. 58, No. 12, pp. 1985-1992, 2001. https://doi.org/10.1001/archneur.58.12.1985
  4. C.M. Hong. "Review of dementia and mild cognitive impairment," Review of Korea Contents Association, Vol. 10, No. 2, pp. 25-30, 2012. https://doi.org/10.20924/CCTHBL.2012.10.2.025
  5. S.H. Ryu. "The clinical significance of cognitive interventions for the patients with mild cognitive impairment," Journal of Korean Neuropsychiatric Association, Vol. 57, No. 1, pp. 23-29, 2018. https://doi.org/10.4306/jknpa.2018.57.1.23
  6. M. Huckans, L. Hutson, E. Twamley, A. Jak, J. Kaye, and D. Storzbach. "Efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI) in older adults:working toward a theoretical model and evidence-based interventions," Neuropsychology Review, Vol. 23, No. 1, pp. 63-80, 2013. https://doi.org/10.1007/s11065-013-9230-9
  7. J.H. Lee, Y.M Choe, M.S. Byun, H.J. Choi, H.W. Baek, B.K. Sohn, et al. "Prevalence and associated factors of depression in mild cognitive impairment," Journal of Korean Geriatric Psychiatry, Vol. 18, No. 2, pp. 86-91, 2014. http://doi.org/10.0000/jkgp.2014.18.2.86
  8. S.S. Mirza, M.A. Ikram, D. Bos, R. Mihaescu, A. Hofman, and H. Tiemeier. "Mild cognitive impairment and risk of depression and anxiety: a population-based study," Alzheimer's & Dementia, Vol. 13, No. 2, pp. 130-139, 2017. https://doi.org/10.1016/j.jalz.2016.06.2361
  9. Y.S. Shim, D.W. Yang, B. Yoon, Y. Lee, C.H. Hong, S.W. Seo, et al. "Clinical predictors for mild cognitive impairment progression in a Korean cohort," Dementia and Neurocognitive Disorders, Vol. 15, No. 3, pp. 68-74, 2016. https://doi.org/10.12779/dnd.2016.15.3.68
  10. F. Zheng, B. Zhong, X. Song, and W. Xie. "Persistent depressive symptoms and cognitive decline in older adults," The British Journal of Psychiatry, Vol. 213, No. 5, pp. 638-644, 2018. https://doi.org/10.1192/bjp.2018.155
  11. J.R. Gatchel, J.S. Rabin, R.F. Buckley, J.J. Locascio, Y.T. Quiroz, H.S. Yang, et al. "Longitudinal association of depression symptoms with cognition and cortical amyloid among community-dwelling older adults," JAMA Network Open, Vol. 2, No. 8, pp. e198964, 2019. https://doi.org/10.1001/jamanetworkopen.2019.8964
  12. D. Lee and S.J. Seong. "Korean national dementia plans: from 1st to 3rd," Journal of the Korean Medical Association, Vol. 61, No. 5, pp. 298-303, 2018. https://doi.org/10.5124/jkma.2018.61.5.298
  13. S.H. Lim. "Cognitive-based intervention for the older adults with mild cognitive impairment: a literature review," Journal of the Korea Convergence Society, Vol. 12, No. 2, pp. 327-336, 2021. https://doi.org/10.15207/JKCS.2021.12.2.327
  14. K.Y. Kim and E.J. Lee. "Effect of cognitive improvement programs for mild cognitive impairment in Korean elderly: a meta-analysis," Korean Journal of Adult Nursing, Vol. 29, No. 2, pp. 177-189, 2017. https://doi.org/10.7475/kjan.2017.29.2.177
  15. W. He, M. Wang, L. Jiang, M. Li, and X. Han. "Cognitive interventions for mild cognitive impairment and dementia: an overview of systematic reviews," Complementary Therapies in Medicine. Vol. 47, pp. 102199, 2019. https://doi.org/10.1016/j.ctim.2019.102199
  16. SJ. Oh, S. Seo, J.H. Lee, M.J. Song, and M.S. Shin. "Effects of smartphone-based memory training for older adults with subjective memory complaints: a randomized controlled trial," Aging and Mental Health, Vol. 22, No. 4, pp. 526-534, 2018. https://doi.org/10.1080/13607863.2016.1274373
  17. G. Savulich, T. Piercy, C. Fox, J. Suckling, J.B. Rowe, J.T. O'Brien, et al. "Cognitive training using a novel memory game on an iPad in patients with amnestic mild cognitive impairment (aMCI)," International Journal of Neuropsychopharmacology, Vol. 20, No. 8, pp. 624-633, 2017. https://doi.org/10.1093/ijnp/pyx040
  18. M.J. Page, J.E. McKenzie, P.M. Bossuyt, I. Boutron, T.C. Hoffmann, C.D. Mulrow, et al. "The PRISMA 2020 statement: An updated guideline for reporting systematic reviews," BMJ, Vol. 372, pp. n71, 2021. https://doi.org/10.1136/bmj.n71
  19. J.A. Sterne, J. Savovic, M.J. Page, R.G. Elbers, N.S. Blencowe, I. Boutron, et al. "RoB 2: a revised tool for assessing risk of bias in randomised trials," BMJ, Vol. 366, pp. 14898, 2019. https://doi.org/10.1136/bmj.l4898
  20. National Evidence-based Healthcare Collaboration Agency. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. 1st ed, p. 270, NECA, 2011.
  21. J. Cohen. Statistical power analysis for the behavioral sciences. 2nd ed, p. 490, Lawrence Erlbaum Associates, 1998.
  22. E.J. Ahn and H. Kang. "Introduction to systematic review and meta-analysis," Korean Journal of Anesthesiology, Vol. 71, No. 2, pp. 103-112, 2018. https://doi.org/10.4097/kjae.2018.71.2.103
  23. S.H. Kim and B.K. Kim. "Effects of cognitive-based interventions of older adults with mild cognitive impairment: a systematic review and meta-analysis," Korean Journal of Adult Nursing, Vol. 30, No. 4, pp. 347-361, 2018. https://doi.org/10.7475/kjan.2018.30.4.347
  24. J.E. Lee. "An integrated literature review of non-pharmacological intervention in older adults with mild cognitive impairment," Journal of Digital Convergence, Vol. 19, No. 3, pp. 471-482. 2021. https://doi.org/10.14400/JDC.2021.19.3.471
  25. H.S. Lee, H.H. Choi, Y.K. Yoo, and S.I. Lim. "Meta-analysis of study of the education and the effective treatment programs for the aged," Journal of Welfare for the Aged, Vol. 56, pp. 93-114, 2012.
  26. L.S Scher, R.A. Maynard, and M. Stagner. "Interventions intended to reduce pregnancy related outcomes among adolescents," Campbell Systematic Reviews, Vol. 2, No. 1, pp. 1-70, 2006. https://doi.org/10.4073/csr.2006.12
  27. V. Orgeta, A. Qazi, A. Spector, and M. Orrell. "Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: a systematic review and meta-analysis," The British Journal of Psychiatry, Vol. 207, No. 4, pp. 293-298, 2015. https://doi.org/10.1192/bjp.bp.114.148130
  28. N.T. Hill, L. Mowszowski, S.L. Naismith, V.L. Chadwick, M. Valenzuela, and A. Lampit. "Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis," American Journal of Psychiatry, Vol. 174, No. 4, pp. 329- 340, 2017. https://doi.org/10.1176/appi.ajp.2016.16030360
  29. K.R. Shin, Y. Kang, M. Kim, D. Jung, and E. Lee. "Prediction of depression among elderly with mild cognitive impairment living in the community," Korean Journal of Adult Nursing, Vol. 24, No. 3, pp. 171-182, 2012. http://doi.org/10.7475/kjan.2012.24.2.171
  30. M.J. Aartsen, T. Van Tilburg, C.H. Smits, K.C. Knipscheer. "A longitudinal study of the impact of physical and cognitive decline on the personal network in old age," Journal of Social and Personal Relationships, Vol. 21, No. 2, pp. 249-266, 2004. https://doi.org/10.1177/0265407504041386