• Journal of Preventive Medicine and Public Health
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• v.56 no.1
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• pp.31-40
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• 2023

Objectives: This study investigated the effect of cognitive impairment on the association between social network properties and mortality among older Korean adults. Methods: This study used data from the Korean Social Life, Health, and Aging Project. It obtained 814 older adults' complete network maps across an entire village in 2011-2012. Participants' deaths until December 31, 2020 were confirmed by cause-of-death statistics. A Cox proportional hazards model was used to assess the risks of poor social network properties (low degree centrality, perceived loneliness, social non-participation, group-level segregation, and lack of support) on mortality according to cognitive impairment. Results: In total, 675 participants (5510.4 person-years) were analyzed, excluding those with missing data and those whose deaths could not be verified. Along with cognitive impairment, all social network properties except loneliness were independently associated with mortality. When stratified by cognitive function, some variables indicating poor social relations had higher risks among older adults with cognitive impairment, with adjusted hazard ratios (HRs) of 2.12 (95% confidence interval [CI], 1.34 to 3.35) for social nonparticipation, 1.58 (95% CI, 0.94 to 2.65) for group-level segregation, and 3.44 (95% CI, 1.55 to 7.60) for lack of support. On the contrary, these effects were not observed among those with normal cognition, with adjusted HRs of 0.73 (95% CI, 0.31 to 1.71), 0.96 (95% CI, 0.42 to 2.21), and 0.95 (95% CI, 0.23 to 3.96), respectively. Conclusions: The effect of social network properties was more critical among the elderly with cognitive impairment. Older adults with poor cognitive function are particularly encouraged to participate in social activities to reduce the risk of mortality.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.227-235
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• 2016

Objectives : The aims of this study were to know the frequency of cognitive dysfunction among patients with autoimmune thyroid disorders, and to reveal influencing factors on it, especially to clarify association with autoimmune thyroid antibodies. Methods : From sixty-five female patients with autoimmune thyroid disorders, demographic data were obtained by structured interview. Their cognitive funtions were measured using the MMSE-K and the MoCA-K tests. Depression was evaluated by the K-HDRS. Results : 1) Among patients with autoimmune thyroid disorders, 7.69% of them were below 24 on the MMSE-K, while 10.77% were below 22 on the MoCA-K. The frequency of cognitive deficit was not significantly different according to having positivity to antimicrosomal antibodies or not. 2) The antimicrosomal antibody-positive patients had significantly higher antithyroglobulin antibody titers, antimicrosomal antibody titers, and TSH concentration, while had significantly lower free T4 levels(p<0.05, respectively). 3) The total scores of the MMSE-K and the MoCA-K had significant correlation with age, marital status, antithyroglobulin antibody titers and K-HDRS(p<0.05, respectively). 4) The regression analysis revealed that variables such as age, education, autoimmune thyroid antibodies, thyroid function and depression did not influence on cognitive function of patients with autoimmune thyroid disorders. Conclusions : Our results could not support that cognitive function of patients with autoimmune thyroid disorders had correlation with autoimmune thyroid antibodies.

• Nutrition Research and Practice
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• v.12 no.3
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• pp.191-198
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• 2018

BACKGROUD/OBJECTIVES: Neuroinflammation plays critical role in neurodegenerative disorders, such as Alzheimer's disease (AD). We investigated the effect of three licorice varieties, Glycyrhiza uralensis, G. glabra, and Shinwongam (SW) on a mouse model of inflammation-induced memory and cognitive deficit. MATERIALS/METHODS: C57BL/6 mice were injected with lipopolysaccharide (LPS; 2.5 mg/kg, intraperitoneally) and orally administrated G. uralensis, G. glabra, and SW extract (150 mg/kg/day). SW, a new species of licorice in Korea, was combined with G. uralensis and G. glabra. Behavioral tests, including the T-maze, novel object recognition and Morris water maze, were carried out to assess learning and memory. In addition, the expressions of inflammation-related proteins in brain tissue were measured by western blotting. RESULTS: There was a significant decrease in spatial and objective recognition memory in LPS-induced cognitive impairment group, as measured by the T-maze and novel object recognition test; however, the administration of licorice ameliorated these deficits. In addition, licorice-treated groups exhibited improved learning and memory ability in the Morris water maze. Furthermore, LPS-injected mice had up-regulated pro-inflammatory proteins, such as inducible nitric oxide synthase (iNOS), cyclooxygenase-2, interleukin-6, via activation of toll like receptor 4 (TLR4) and nuclear factor-kappa B ($NF{\kappa}B$) pathways in the brain. However, these were attenuated by following administration of the three licorice varieties. Interestingly, the SW-administered group showed greater inhibition of iNOS and TLR4 when compared with the other licorice varieties. Furthermore, there was a significant increase in the expression of brain-derived neurotrophic factor (BDNF) in the brain of LPS-induced cognitively impaired mice that were administered licorice, with the greatest effect following SW treatment. CONCLUSIONS: The three licorice varieties ameliorated the inflammation-induced cognitive dysfunction by down-regulating inflammatory proteins and up-regulating BDNF. These results suggest that licorice, in particular SW, could be potential therapeutic agents against cognitive impairment.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.484-488
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• 2013

Objective : To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke. Methods : The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination. Results : Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items. Conclusion : Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.

• Journal of Korean Academy of Nursing
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• v.51 no.3
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• pp.294-304
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• 2021

Purpose: This study aimed to investigate objectively measured physical activity (PA) in institutionalized older adults with mild cognitive impairment (MCI) and to elucidate the influence of autonomic nervous function, salivary cortisol, and PA on cognitive functions based on neurovisceral integration model. Methods: Overall cognitive function was evaluated using the mini-mental state examination (MMSE) and executive function was evaluated using semantic verbal fluency test and clock drawing test. Actigraph for PA, HRV and sAA for autonomous function, and the geriatric depression scale for depression were used. Saliva specimens were collected in the morning for sAA and cortisol. Results: Ninety-eight older adults from four regional geriatric hospitals participated in the study. They took 4,499 steps per day on average. They spent 753.93 minutes and 23.12 minutes on average in sedentary and moderate-to-vigorous activity, respectively. In the multiple regression analysis, lower salivary cortisol level (β = - .33, p = .041) and greater step counts (β = .37, p = .029) significantly improved MMSE score. Greater step count (β = .27, p = .016) also exerted a significant influence on verbal fluency, and greater sAA (β= .35, p = .026) was significantly associated with a better clock drawing test result. Conclusion: Salivary cortisol, sAA and physical activity were significantly associated with cognitive functions. To prevent older adults from developing dementia, strategies are needed to increase their overall PA amount by decreasing sedentary time and to decrease salivary cortisol for cognitive function, and to maintain their sympathetic nervous activity for executive function.

• Journal of Korean Academy of Nursing
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• v.53 no.4
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• pp.453-467
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• 2023

Purpose: This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R², which indicates the difference between the model's R² with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms.

• Development and Reproduction
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• v.21 no.4
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• pp.417-424
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• 2017

Alzheimer's disease (AD) is neurodegenerative disease, characterized by the progressive decline of memory, cognitive functions, and changes in personality. The major pathological features in postmortem brains are neurofibrillary tangles and amyloid beta ($A{\beta}$) deposits. The majority of AD cases are sporadic and age-related. Although AD pathogenesis has not been established, aging and declining mitochondrial function has been associated. Mitochondrial dysfunction has been observed in AD patients' brains and AD mice models, and the mice with a genetic defect in mitochondrial complex I showed enhanced $A{\beta}$ level in vivo. To elucidate the role of mitochondrial complex I in AD, we used SH-SY5Y cells transfected with DNA constructs expressing human amyloid precursor protein (APP) or human Swedish APP mutant (APP-swe). The expression of APP-swe increased the level of $A{\beta}$ protein in comparison with control. When complex I was inhibited by rotenone, the increase of ROS level was remarkably higher in the cells overexpressing APP-swe compared to control. The number of dead cell was significantly increased in APP-swe-expressing cells by complex I inhibition. We suggest that complex I dysfunction accelerate amyloid toxicity and mitochondrial complex I dysfunction in aging may contribute to the pathogenesis of sporadic AD.

• Journal of Korean Biological Nursing Science
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• v.24 no.2
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• pp.77-85
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• 2022

Purpose: Aging process comes with cognitive impairment due to decreased neuronal cell number, activity, and neuronal circuit. Alteration of inhibitory neurons contributes to cognitive impairment in normal aging and is responsible for disrupting the excitation/inhibition balance by reducing the synthesis of gamma-aminobutyric acid (GABA). Morus nigra (Mulberry) is a natural physiologically active substance that has been proven to have anti-oxidant, anti-diabetic, and anti-inflammatory effects through many studies. This study aimed to evaluate the effects of the mulberry extract (ME) on cognitive function through anti-oxidant enzyme and GABAergic neuronal activity in aged rat brain. Methods: Sprague Dawley rats were randomly assigned as the young group (8 weeks, n= 8), aging group (67 weeks, n= 8), and aging+ mulberry extract group (67 weeks, n= 8). The aging+ mulberry extract group was orally administered 500 mg/kg/d mulberry extract for 6 weeks. Results: The aging+ mulberry extract group improved spatial and short-term memory. The antioxidant potential of ME increased the expression of superoxide dismutase-1 (SOD-1) and decreased inducible nitric oxide synthase (iNOS). Also, the aging+ mulberry extract group significantly increased the expression of GABAergic interneuron in hippocampus cornu ammonis1 (CA1) compared to the aging group. Conclusion: The number of GABAergic inhibitory interneurons was deceased and memory functions in the aging process, but those symptoms were improved and restored by mulberry extract administration.

• Journal of Korean Academy of Nursing
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• v.33 no.6
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• pp.705-712
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• 2003

Purpose: The purpose of this study was to explore factors that influence care dependency of institutionalized patients with dementia. Method: This study utilized descriptive correlational design. The convenience sample was composed of 110 residents with dementia of two long-term care facilities in Korea. Stepwise multiple regression was used to identify significant factors influencing care dependency in patients with dementia. Care dependency was measured using the Care Dependency Scale, Korean version(CDS-K). Cognition was measured by the MMSE-K. Functional disability was measured by the PULSES Profile. Behavioral dysfunction was measured by the modified E-BEHAVE AD. Result: Care dependency was significantly influenced by cognition, functional disability, behavioral dysfunction, and duration of dementia. This regression model explained 61 % of the variances in care dependency. Cognition explained 37% of the variances, and functional disability explained 21% of the variances. Conclusion: Results of this study suggest that professional caregivers intervene more effectively in caring for their patients with dementia by recognizing the patients cognitive, functional, behavioral disability, and its periodic change. Individually, remaining abilities-focused intervention should be applied to enhance patient to be dependent and to prevent unnecessary independency.

• Nutrition Research and Practice
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• v.12 no.5
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• pp.415-425
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• 2018

BACKGROUND/OBJECTIVE: As aging progresses, the number of patients with cognitive impairment also increases. Cognitive function is not generally correlated with diet, and there is debate over that association. Thus, the present study aimed to investigate the association between dietary intake and cognitive function among adults aged 50 years or older. SUBJECTS/METHODS: Between July 2017 and March 2018, 324 adults aged over 50 years from Gwangju Sun-Han hospital participated in a dietary survey. The frequency of food intake and related information were collected using a semi-quantitative food frequency questionnaire (SQ-FFQ) and determining the mini-mental state examination (MMSE) level for 276 participants. The association between dietary intake and cognitive function was assessed by performing logistic regression analysis. RESULTS: Depending on the MMSE score, the participants' age, education level, inhabitation status, medications, alcohol consumption, sleep duration, physical activity, and short geriatric depression scale score were significantly different (P < 0.05). Moreover, those participant characteristics were associated with either decreased or increased odds ratios (OR) for the risk of mild cognitive impairment (MCI). Based on analysis of the participants' intake of 112 detailed food items, which were categorized into 20 food types, intakes of cooked white rice (< 2 times/day compared with ${\geq}3$ times/day) (P < 0.05), properly cooked rice with other grains and legumes (P < 0.001), fruits (P < 0.05), milk (low fat and normal) (P = 0.044), liquid-type yogurt (P = 0.019), and curd-type yogurt (P = 0.015) were found to significantly decrease the OR for the risk of MCI. CONCLUSIONS: Associations were significant between the risk of MCI and the intake of certain food types. Specifically, a moderate intake of cooked white rice and an adequate intake of whole grains, fruits, milk, and dairy products were associated with reduced risks of MCI among adults aged over 50 years.