• The Monthly Diabetes
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• s.288
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• pp.21-26
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• 2013

1990년대 이후 국내 노령인구 비율이 급격히 증가하고 있다. 2018년에는 전 인구의 14%, 2026년에는 전 인구의 20% 정도를 차지할 것으로 예상되고 있다. 노령 인구는 만성질환의 유병율이 높으며 이와 함께 노령 인구의 특성상 인지기능저하가 동반되는 경우가 많아 환자 관리에 있어서 어려움이 많다. 당뇨병은 인지기능장애의 주요 위험 인자를 차지하고 있다. 그러나, 일반적으로 당뇨병 치료에 있어 혈당관리, 미세혈관 및 대혈관 합병증에 대한 관심 및 관리는 잘 이루어지고 있지만, 이에 반해 인지기능장애 부분에 있어서는 다소 간과하고 있는 부분이 많다. 당뇨병이 있는 환자에서 치매 발생 위험율이 2배 이상을 높은 점을 감안할 때, 고령 환자에서는 인지기능장애에 대한 세심한 관심이 필요하다.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.177-185
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• 1995

외상후 뇌손상은 대표적이며, 가장 중요한 신경정신계 질환의 하나이다. 더욱이 외상후 뇌손상 환자들은 각종의 사고 및 산업재해 등으로 인해 그 수가 급증하고 있으며, 특히 인지기능의 장애로 인한 다양한 기질성 정신장애로 고통을 겪게 된다. 따라서 외상후 뇌손상은 손상의 시점에서부터 정확하고 올바른 평가는 물론 손상후의 경과 및 치료대책의 수립에 있어서 체계적이며 종합적인 신경인지기능의 평가는 필수적이다. 왜냐하면 신경인지기능평가는 뇌의 손상부위와 이와 관련된 기능장애 및 행동의 변화에 대한 객관적인 자료를 제시해 주기 때문이다. 신경인지기능 평가의 영역은 지각, 운동기능은 물론 주요인지기능인 기억, 언어, 실행 및 감정조절능력에 이르기까지 다양하며, 외상후 뇌손상환자들은 손상부위 및 정도에 따라 신경인지기능의 장애를 초래하게 된다. 대표적인 신경인지기능평가 도구로는 KWIS, Halstead-Reitan, Luria-Nebraska batteries, 특히 전두엽기능검사인 Wisconsin Card Sorting Test (WCST)를 비롯하여, 현재는 PC/S Vienna Test System 및 Stim등의 각종 전산화 인지기능검사가 개발되어 임상에서 활발히 사용되고 있다. 즉 외상후 뇌손상환자를 위한 신경인지기능평가의 목적은 뇌손상과 관련된 신경인지기능장애를 정확히 평가하여, 환자 개개인에 적합한 인지재활치료 계획을 수립하는데 있다. 물론 여기에는 신경정신상태검사(neuropsychiatric mental status examination)를 통하여 외상 후 뇌손상의 경과 및 예후에 결정적인 영향을 미칠 수 있는 나이, 의식소실 및 외상후 기억 손상 시간의 정확한 측정은 물론 심리 사회 문화적인 상태와 두부외상전 환자의 지적수준 및 사회 적용기능이 함께 평가되어야 할 것이다.

• 한국노년학
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• v.37 no.4
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• pp.813-833
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• 2017

The purpose of this study was to classify the results of previous studies on the cognitive function improvement program of the elderly into the cognitive impairment group and the normal group to compare the effect sizes of the groups using meta - analysis. Among the previous studies on cognitive function improvement programs reported in Korea for the last five years, 86 were selected and the effect sizes were summarized using meta-analysis. As a result of the study, the overall average effect size showed a large effect size in both groups. The effect sizes of the intervention types were high for the cognitive impairment group, and the exercise and cognitive-based interventions were similar for the normal group. The gender effect size was higher for the women with cognitive impairment group, and higher for the combined case with normal group. The effect sizes according to group size were higher for 20 persons in cognitive impairment group and higher for 21~40 persons in normal group. The total number of sessions in both groups was higher than 32 times, The number of sessions per week was 3 times for the cognitive impairment group, 4 to 6 times for the normal group. The duration of activity was 55~60 minutes in cognitive impairment group and 70~180 minutes in normal group as the number of sessions and activity time increased the effect size was higher in normal group. This study will be meaningful in that it provided basic data necessary for future program development by comparing and analyzing the effect sizes of the cognitive function improvement program type and the activity factors between the cognitive impairment group and the normal group.

• Journal of Digital Convergence
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• v.15 no.3
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• pp.393-403
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• 2017

The purpose of this study was to investigate the degree of cognitive impairment for the elders taking part in activities at senior community center and to identify the multiple factors affecting the cognitive dysfunction of them. Data were collected for the 375 elders taking part in activities at senior community center at 4 different areas of dong, up, and myun of C-city from June 2016 to July 2016, and their general characteristics as well as health-related characteristics, depression, and cognitive dysfunction were investigated and analyzed. The results of this study showed that cognitive dysfunction was affected by the age, education, economic support, history of stroke, and exercise. The risk of cognitive dysfunction was 3.50 times higher in patients over 80 years old than patients below 74 years old(p=.002), and the lower the level of education showed the higher the risk of cognitive dysfunction(p=.036)(p<.001). In addition, the risk of cognitive dysfunction was low in the absence of a history of stroke(p=.033), and the risk of cognitive dysfunction increased by 1.84 times if they do not exercise(p=.044). Based on the present study, It is required to consider the risk factors for cognitive dysfunction efforts to prevent and manage cognitive impairment before the onset of cognitive dysfunction.

• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.630-642
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• 1997

The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

• Korean Journal of Social Welfare Studies
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• v.44 no.2
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• pp.327-358
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• 2013

This study aimed to analyze the trajectories of cognitive function and functional disability, and to identify the impacts of socio-demographic factors on the two variables. Based on the assumption that there are differences according to the progress of cognitive impairment, it focused on examining the differences in trajectories of cognitive function and functional disability between two groups: dementia conversion group and dementia non-conversion group among cognitively normal older adults. This study was conducted based on the data from a 3-wave panel study of a sample of 966 Yeoncheon elderly cohort aged 65 and over between 1997 and 2003. Latent growth curve model and multi-group structural equation modeling were used to examine the hypothesis. Results revealed that dementia conversion group exhibited faster rate of cognitive decline as well as lower initial cognitive level. Difference between two groups was not significant in the initial level of functional disability, yet dementia conversion group showed greater degree of deterioration in the functional disability over time than dementia non-conversion group did. In terms of the influence of socio-demographic factors on cognitive function and functional disability, the cognitive decline was more drastic in the female group, whereas functional decline was more apparent for the male group. The level of education in early life had a strong impact on the cognitive function in later life. Based on these findings, practical implication for high risk groups in cognitive function and functional disability were discussed.

• Sleep Medicine and Psychophysiology
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• v.21 no.1
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• pp.5-13
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• 2014

Objectives: Depression, sleep complaints and cognitive impairments are commonly observed in the elderly. Elderly subjects with depressive symptoms have been found to show both poor cognitive performances and sleep disturbances. However, the relationship between sleep complaints and cognitive dysfunction in elderly depression is not clear. The aim of this study is to identify the association between sleep disturbances and cognitive decline in late-life depression. Methods: A total of 282 elderly people who underwent nocturnal polysomnography in a sleep laboratory were enrolled in the study. The Korean version of the Neuropsychological Assessment Battery developed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was applied to evaluate cognitive function. Depressive symptoms were assessed with the geriatric depression scale (GDS) and subjective sleep quality was measured using the Pittsburg sleep quality index (PSQI). Results: The control group ($GDS{\leq}9$) when compared with mild ($10{\leq}GDS{\leq}16$) and severe ($17{\leq}GDS$) depression groups, had significantly different scores in the Trail making test part B (TMT-B), Benton visual retention test part A (BVRT-A), and Stroop color and word test (SCWT)(all tests p<0.05). The PSQI score, REM sleep duration, apnea-hypopnea index and oxygen desaturation index were significantly different across the three groups (all indices, p<0.05). A stepwise multiple regression model showed that educational level, age and GDS score were predictive for both TMT-B time (adjusted $R^2$=35.6%, p<0.001) and BVRT-A score (adjusted $R^2$=28.3%, p<0.001). SCWT score was predicted by educational level, age, apnea-hypopnea index (AHI) and GDS score (adjusted $R^2$=20.6%, p<0.001). Poor sleep quality and sleep structure alterations observed in depression did not have any significant effects on cognitive deterioration. Conclusion: Older adults with depressive symptoms showed mild sleep alterations and poor cognitive performances. However, we found no association between sleep disturbances (except sleep apnea) and cognitive difficulties in elderly subjects with depressive symptoms. It is possible that the impact of sleep disruptions on cognitive abilities was hindered by the confounding effect of age, education and depressive symptoms.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.36-43
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• 2003

Objectives: The purpose of this study was to evaluate the difference of cognitve function among patients with posttraumatic stress disorder according to severity of symptoms. Methods: The subjects were 90 psychiatric inpatients and outpatients with posttraumatic stress disorer(by DSM-IV criteria) after traffic accident. The severity of symptoms was assessed by MMPI subscales; depression, psychasthenia, schizophrenia. The impairment of cognitive function was assessed by Korean Wechsler Intelligence Scale(K-WAIS). Based on scores of the MMPI subscales, the patients were divided into high group(above 70 percentile) and low group(below 30 percentile). We estimated the difference of the K-WAIS score and subtest score in the low group and high group of the MMPI subscales by indedpendent t-test. Results: The scores of high group is significantly higher in the subtests of information, vocabulary, similarity, picture completion, and picture arrangement than the low group for psychasthenia subscale of MMPI. And the score of high group is significantly higher in full scale I.Q., verbal I.Q., performance I.Q., verbal subscales except digit span and simiarity, and performance subscales than low group for schiozphrenia subscale of MMPI. Conclusion: It was found cognitive function was more impaired in the group of PTSD with severe symptom compared to the group of PTSD with mild symptoms. We suggest that psychiatrist should consider various cognitive approaches as well as pharmacotherapy in the management of PTSD.

• 한국노년학
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• v.39 no.2
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• pp.389-404
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• 2019

The present study aims to examine the relationship between self-reported sensory impairment and cognitive function among older adults in Korea. Drawn from the 2017 Survey of Living Conditions and Welfare Needs Korean Older Persons, a total of 10,082 adults aged 65 and over were included in analyses. Results from hierarchial multiple regression analysis show that those who reported greater subjective discomfort about vision, hearing, and oral function were more likely to have poor cognitive function. Results from hierarchial logistic regression analysis show. Results from logistic regression analysis show that having hearing and oral discomfort increased the a risk for dementia. Findings suggest that it is necessary to manage sensory function of the elderly at the government level and to develop self-evaluation tools to monitor changes in sensory function for older adults. Future research should target finding effective ways to improve health of older adults.

• Journal of Korea Entertainment Industry Association
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• v.15 no.7
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• pp.215-223
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• 2021

The purpose of this study is to investigate the effect of computerized cognitive therapy on cognitive function and Instrumental Activities of Daily Living for elderly people with mild cognitive impairment living in the community. 22 MCI elderly people were randomly assigned to 11 experimental group and 11 control group. For a total of 10 weeks, 3 times a week, 30 minutes per session, the experimental group received CoTras and the control group received traditional cognitive rehabilitation. Neurobehavioral Cognitive Status Examination(NCSE) and Korean Instrumental Activities of Daily Living(K-IADL) were used to investigate the changes in cognitive function and performance of instrumental activities of daily living before and after the intervention. As a result of the study, the experimental group showed improvement in overall cognitive function, including attention and memory, and performance in IADL. The use of CoTras may be considered to improve cognitive function and performance of instrumental activities of daily living for the elderly with mild cognitive impairment in the community.