• Title/Summary/Keyword: Cognitive Function Test

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Risk Factors for Delirium after Spine Surgery in Elderly Patients

  • Seo, Jin Suk;Park, Seung Won;Lee, Young Seok;Chung, Chan;Kim, Young Baeg
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.28-33
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    • 2014
  • Objective : Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. Methods : Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. Results : Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were $19.1{\pm}5.4$, $0.9{\pm}0.6$, and $3.3{\pm}1.1$. These were significantly lower than those of Group B ($25.6{\pm}3.4$, $0.5{\pm}0.2$, and $2.1{\pm}0.7$) (p<0.05). BIS was lower in Group A ($30.2{\pm}6.8$ compared to $35.4{\pm}5.6$ in group B) (p<0.05). The number of BIS <40 were $5.1{\pm}3.1$ times in Group A, $2.5{\pm}2.2$ times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. Conclusion : Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.

Lactate consumption mediates repeated high-intensity interval exercise-enhanced executive function in adult males

  • Cho, Hae-Sung;Lee, Won Sang;Yoon, Kyeong Jin;Park, Soo Hong;Shin, Hyung Eun;Kim, Yeon-Soo;Chang, Hyukki;Moon, Hyo Youl
    • Korean Journal of Exercise Nutrition
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    • v.24 no.4
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    • pp.15-23
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    • 2020
  • [Purpose] Lactate is a principal energy substrate for the brain during exercise. A single bout of high-intensity interval exercise (HIIE) can increase the blood lactate level, brain lactate uptake, and executive function (EF). However, repeated HIIE can attenuate exercise-induced increases in lactate level and EF. The lactate levels in the brain and blood are reported to be correlated with exercise-enhanced EF. However, research is yet to explain the cause-and-effect relationship between lactate and EF. This study examined whether lactate consumption improves the attenuated exercise-enhanced EF caused by repeated HIIE. [Methods] Eleven healthy men performed two sets of HIIE, and after each set, 30 min were given for rest and examination. In the 2nd set, the subjects consumed experimental beverages containing (n = 6) and not containing (n = 5) lactate. Blood, cardiovascular, and psychological variables were measured, and EF was evaluated by the computerized color-word Stroop test. [Results] The lactate group had a higher EF (P < 0.05) and tended to have a higher blood lactate level (P = 0.082) than the control group in the 2nd set of HIIE. Moreover, blood lactate concentration was correlated with the interference score (i.e., reverse score of EF) (r = -0.394; P < 0.05). [Conclusion] Our results suggest that the attenuated exercise-enhanced EF after repeated HIIE can be improved through lactate consumption. However, the role of lactate needs to be elucidated in future studies, as it can be used for improving athletes' performance and also in cognitive decline-related clinical studies.

NEUROPSYCHOLOGY IN NEURODEVELOPMENT (발달 신경심리학)

  • Shin Min-Sup;Kim Hyun-Mi
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.33-46
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    • 2005
  • First, the author reviewed the relationship between human brain development and cognitive functions such as attention, perception, memory, and language. And then Luria's neurodevelopmental theory and its application on the Neuropsychological test battery for children were reviewed. Finally, various assessment tools to evaluate attention, intellectual function, visual-perception, visual-motor coordination, and executive function were examined.

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Relationship among Plasma Homocysteine, Folate, Vitamin $B_{12}$ and Nutrient Intake and Neurocognitive Function in the Elderly (노인의 혈중 호모시스테인, 엽산, 비타민 $B_{12}$ 수준 및 영양소 섭취 상태와 신경인지기능과의 관련성)

  • Kim, Hee-Jung;Kim, Hye-Sook;Kim, Ki-Nam;Kim, Ggot-Pin;Son, Jung-In;Kim, Seong-Yoon;Chang, Nam-Soo
    • Journal of Nutrition and Health
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    • v.44 no.6
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    • pp.498-506
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    • 2011
  • This study examined the relationship among plasma homocysteine, folate, and vitamin $B_{12}$ levels and neurocognitive function in 118 community-dwelling elderly subjects (mean age, $75.1{\pm}6.7$ years). The Mini-Mental State Examination (MMSE-KC) was used to screen and assess neurocognitive function in the participants. Dietary intake data including the use of dietary supplements were obtained using the 24-hour recall method by well-trained interviewers. Plasma folate and vitamin $B_{12}$ concentrations were analyzed by radioimmunoassay, and homocysteine was assessed by a high performance liquid chromatography-fluorescence method. The proportions of participants with suboptimal levels of plasma folate (< 3 ng/mL), vitamin $B_{12}$ (< 221 pmol/mL), and homocysteine (> $15{\mu}mol/L$) were 16.1%, 5.9%, and 21.2%, respectively. A multiple regression analysis showed that plasma homocysteine was negatively associated with plasma folate and vitamin $B_{12}$ levels. The MMSE-KC test scores were significantly associated with plasma homocysteine and folate, but not with vitamin $B_{12}$, after adjusting for age, gender, body mass index, living with spouse, education, current smoking, energy intake, and chronic diseases such as hypertension, diabetes, thyroid disease, dyslipidemia, stroke, and cardiovascular disease. A general linear model adjusted for covariates revealed that MMSE-KC test scores increased from the lowest to the highest quartiles of vitamin $B_1$, vitamin $B_2$, vitamin $B_6$, vitamin $B_{12}$, and vitamin C intake (p for trend = 0.012, 0.039, 0.014, 0.046, 0.026, respectively). These results indicate that the problem of folate inadequacy and hyperhomocysteinemia are highly prevalent among community-dwelling elderly people and that dietary intake of the B vitamins and vitamin C is positively associated with cognitive function scores.

Development of the Bedside Neurocognitive Function Localization Test(BNLT) I : A Design (간이 신경 인지기능 국재화 검사의 개발 I : 고안)

  • Lee, Young-Ho;Jung, Hyo-Kyung;Hoe, Si-Young;Koh, Young-Taek;Park, Byung-Kwan
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.133-142
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    • 1999
  • Recently, with increasing the number of patients with head injury and cerebrovascular accident, there has been an increasing need for the useful assessment tools of brain dysfunction and it's localization. With the advances in the neuroscience since the mid-1970s, particularly in the areas of neuroanatomical tracing, neuroimaging, and improved behavioraltest design, it has been possible to develop a more precise understanding and localization of brain dysfunction. However, these equipments are not readily available in the private clinics and too expensive to use as a screening tool to all suspected patients with brain dysfunction. Although several screening tests such as Mini-Mental States Examination(MMSE) or Brief Cognitive Rating Scale(BCRS) are simple in use and useful for the brief assessment of brain dysfunction, these are also limited in using for localization of brain dysfunction because of their simplicity. With increasing need of the assessment tool which is able to localize the dysfunction more precisely in the clinical practice, we planned to develop the new assessment tool, the Bedside Neurocognitive Function Localization Test(BNLT) which is suitable for this purpose. The BNLT was designed to be utilized for localizing brain dysfunction effectively and readily in the clinical practice. We introduced the whole process of designing the BNLT in this manuscript.

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Development of Beat Processing Device for Rhythm Production Assessment (리듬 산출 검사 어플리케이션 Beat Processing Device 개발)

  • Chong, Hyun Ju;Mun, Ju Hyoung;Han, Eunyoung;Choi, Jin Hee
    • Journal of Digital Convergence
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    • v.18 no.7
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    • pp.215-222
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    • 2020
  • The aim of this study was to develop a mobile application 'Beat Processing Device (BPD)' to record and quantify the data for the performance accuracy of rhythm production. BPD has been developed in three phases. First, we reviewed studies that used rhythm as main intervention strategy to improve cognitive functioning of older adults, and derived four basic rhythm idioms. Second, we developed an iOS-based mobile application, optimized the device, the instrument tone, and the measurement variables through preliminary test. Lastly, we tested the mobile application by comparing the performance data obtained from MIDI and BPD from 60 older adults. The device was shown to be reliable and consistent with other mode of measurement and analysis. Conclusively, BPD can be a useful tool for assessing rhythm production ability in the course of cognitive skills training.

Association between Cognitive function, Behavioral and Psychological Symptoms of Dementia and Temporal Lobe Atrophy in Patients with Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머형 치매 및 경도인지장애 환자에서 인지기능 및 행동심리증상과 내측두엽 위축의 연관성)

  • Jeong, Jae Yoon;Lee, Kang Joon;Kim, Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.155-163
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    • 2019
  • Objectives : The aim of this study was to compare severity, neurocognitive functions, and behavioral and psychological symptoms of dementia (BPSD) according to the degree of temporal lobe atrophy (MTA) in Korean patients with dementia due to Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease. Methods : Participants were 114 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. Severity was evaluated with Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Neurocognitive functions was evaluated with the Korean version of Short Blessed Test (SBT-K) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). BPSD was evaluated with the Korean version of the Neuropsychiatric Inventory (K-NPI). Independent t-test was performed to compare severity, neurocognitive functions, and BPSD between two groups. Results : The group with high severity of MTA showed significantly lower scores in CDR, SBT-K, MMSE-KC, modified Boston naming test, word list recognition, and word list memory (p<0.05). There were no differences in K-NPI scores between two groups. Conclusions : Severity and neurocognitive functions of dementia had significant positive association with MTA, but BPSD had no association with MTA. Evaluating MTA seems to have potential benefit in diagnosing and treating neurocognitive impairments in the elderly. Further evaluation is needed to confirm the association between certain brain structures and BPSD.

The Normative Study of the Montreal Cognitive Assessment-Korea (MoCA-K) as Instrument for Screening of Mild Cognitive Impairment (MCI) (경도인지장애 선별검사로서 Montreal Cognitive Assessment-Korea (MoCA-K)의 규준 연구)

  • Kwak, Ho-Soung;Kim, Sun-Ho
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.37-45
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    • 2021
  • Purpose : This study aimed to present normative data and cut-off points for older Korean adults completing the Montreal Cognitive Assessment - Korean (MoCA-K), which is used as a screening test for mild cognitive impairment in Korea. Methods : A total of 195 healthy adults ≥60 years were recruited. All participants completed the MoCA-K and the Korean - Mini-Mental State Examination (MMSE-K) to assess their cognitive function. Participants were divided into six groups based on their age: 60-64 years, 65~69 years, 70~74 years, 75~79 years, 80~84 years, and 85~89 years. Results : The results revealed that MoCA-K score decreased significantly with age (mean score ± standard deviation [SD]; 27.63±2.80 in subjects aged 60~64 years; 27.00±2.39 in subjects aged 65~69 years; 24.94±2.96 in subjects aged 70~74 years; 24.74±3.37 in subjects aged 75~79 years; 22.59±4.72 in subjects aged 80~84 years; and 18.83±5.38 in subjects aged 85~89 years; p<.001). Additionally, MoCA-K score also increased significantly with educational level (mean score±standard deviation [SD]; 19.95±4.78 in no formal education group; 24.95±2.22 in elementary school graduated group; 26.35±2.72 in middle school graduated group; 28.32±1.36 in high school graduated group; and 28.50±1.51 in more than college graduated group; p<.001). The optimal cut-off points were 24/25 for 60~69 years old group, 21/22 for 70~79 years old group, 17/18 for 80~84 years old group, and 13/14 for 85~89 years old group. The optimal cut-off points were 15/16 for individuals who were illiterate, 22/23 for individuals with 6 years of education, 22/24 for individuals with 9 years of education, and 26/27 for individuals with 12 or more years of education. Conclusions : This study presents normative data and cut-off points for the MoCA-K in older Korean adults. This data will facilitate more accurate detection and follow-up of the risk of mild cognitive impairment in this population, taking into consideration age and education. Future studies are required that should focus on the cut-off score on the level of education according to age.

An Association Between Apolipoprotein E ${\varepsilon}4$ and Cognitive Function in Community-Dwelling Elders with Questionable Dementia (일 지역사회거주 치매의심 노인에서 Apolipoprotein E ${\varepsilon}4$와 인지기능 간의 연관성)

  • Moon, Seok Woo;Seo, Jeong Seok;Nam, Beom Woo;Choi, Jin Young;Lee, Chang Hoon;Park, Kyoung Un;Kim, Ki Woong
    • Korean Journal of Biological Psychiatry
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    • v.15 no.1
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    • pp.5-13
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    • 2008
  • Objectives : It was the aim of the present paper to examine the impact of the apolipoprotein E(APOE) ${\varepsilon}4$ on cognitive performance in community-dwelling elderly samples with 'questionable dementia'. Methods : Total 295 samples who were diagnosed with 'questionable dementia' in the recent year and completed the Korean version of the Consortium Establish a Registry for Alzheimer's Disease(CERAD-K) neuropsychological assessment protocol, were recruited. The CDR test established score of 0.5. Genomic DNA was extracted from the venous blood and APOE genotyping was done in this group. Their cognitive performance was compared by the occurrence of the APOE ${\varepsilon}4$ allele. Results : The impact of ${\varepsilon}4$ allele was significant in the Word List Recall Test(WLRT, F=4.511, df=1, p=0.035). The 'young-old' group aged 75 years and under had a significantly lower performance on the Word List Recall Test(WLRT, F=5.090, df=1, p=0.015), but the 'old-old' group over 75 years of age had not significantly different performance on the all the item of tests in ${\varepsilon}4$+ allele group. Conclusion : The conclusion to be drawn here is that community-dwelling elderly samples with ${\varepsilon}4$ allele in 'questionable dementia' had a significantly lower performance on the Word List Recall Test in the CERAD-K neuropsychological test batteries and the effect was prominent in the 'young-old' age group.

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Effects of oral-motor function on PCC and intelligibility in children with Down's syndrome and typically developing children (다운증후군아동과 일반아동의 구강운동기능이 자음정확도 및 말명료도에 미치는 영향)

  • Kang, Eunhye;Sim, Hyunsub
    • Phonetics and Speech Sciences
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    • v.9 no.2
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    • pp.125-135
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    • 2017
  • The current study examines PCC (percentage of correct consonant), speech intelligibility, and oral motor function between the group of typically developing children and the group of children with Down's syndrome. To 15 children with Down's syndrome (mean CA: 9;7) and 15 typically developing children on receptive language age, the following tests were administered: K-WPPSI (2001), Picture Vocabulary Test (Kim et al., 1995), Oral and Speech Motor Control Protocol for total oral functional score (Robbins et al., 1987), DDK and Assessment of Phonology and Articulation for Children (APAC, Kim et al., 2007) for PCC and speech intelligibility. Pearson correlation coefficients were computed for the total oral functional score, PCC and DDK of each group. The statistical analysis showed that there is no significant difference in total functional score and DDK when IQ was controlled. There was a significant correlation between total oral functional score and PCC in the Down's syndrome group and a significant correlation between total oral functional score and intelligibility in the Down's syndrome group whether IQ was controlled or not. The findings suggest that both cognitive ability and overall oral motor function need to be considered for the intervention to enhance PCC or speech intelligibility of children with Down's syndrome.