• 동의신경정신과학회지
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• 제30권3호
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• pp.185-198
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• 2019

Objectives: The purpose of this study was to identify the effectiveness of Korean medicine treatment in mild cognitive impairment (MCI) among a group of community dwelling elderly. Methods: Two-hundred and twenty-nine elderly living in a community and diagnosed with MCI were recruited. Participants were evaluated with various instruments such as the Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Korean version of Montreal Cognitive Assessment (MoCA-K). Korean medicine treatment consisted of herbal medicine, acupuncture, and pharmacoacupuncture. The change in cognitive ability was assessed by using the MMSE-DS and the MoCA-K. Data were analyzed by SPSS/WIN 22.0 using the paired t-test, and the ANOVA. Results: The MMSE-DS and the MoCA-K score generally increased after six months of Korean medicine treatment and the differences in both instruments were statistically significant. Additionally, some consecutive participants maintained long-term cognitive improvement. When analyzed specifically by herbal medicine group based on syndrome differentiation and pharmacoacupuncture group, most showed improvement in the MMSE-DS and the MoCA-K but not all data were statistically significant. The satisfaction score was mostly high and most participants were willing to re-participate in the program. Conclusions: Korean medicine treatment may contribute to the improvement and prevention of cognitive decline in the elderly. However, further systematic research based on large scale sample data and standardized protocols is needed to uplift the welfare and mental health of the elderly.

• 생명과학회지
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• 제29권6호
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• pp.747-753
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• 2019

인지기능 저하는 장 단기 기억 및 주의력 소실과 우울증, 불안증의 증가를 특징으로 한다. 또한, 인지기능 저하는 알츠하이머, 파킨슨병과 같은 다양한 퇴행성 뇌질환과 연관되어 있다. 경제적 부담, 안전 위협을 포함하는 인지기능 저하와 관련된 사회적 문제는 고령화가 진행됨에 따라 증가하고 있다. 이러한 문제를 해결하기 위해 전 세계적으로 많은 연구가 수행되고 있다. 일반적으로 인지기능 저하를 유발할 가능성이 있는 원인으로는 노화에 따른 대사 및 호르몬 불균형, 감염, 약물 오남용, 신경세포 손상 등이 알려져 있지만 다양한 요인이 관련되어 있으므로 원인 규명이 어려운 한계점 때문에 뚜렷한 치료전략 수립이 어려운 실정이다. 최근의 연구에 따르면 퇴행성 뇌질환 발생의 원인과 이에 대한 치료전략 수립에 있어서 장내미생물의 역할이 중요하게 제시되고 있다. 특히, 알츠하이머병과 파킨슨병에서 장내미생물 조성의 변화 및 이들에 의한 대사산물에 따른 분자생물학적, 신경행동학적 증상의 변화가 밝혀졌다. 알츠하이머병 동물모델에서 장내미생물의 변화는 NMDA 수용체와 글루탐산의 변화를 통해 기억능력 소실을 야기하였다. 반면, 알츠하이머병 동물모델에 프로바이오틱스를 투여하였을 때, 비정상적인 신경학적 행동이 유의적으로 감소하였다. 파킨슨병은 장내미생물 군집의 변화와 직접적인 연관성을 보였으며 이는 이차적 증상인 변비 발생에도 영향을 미치는 것으로 나타났다. 파킨슨병 동물모델에 투여한 프로바이오틱스는 단쇄지방산 중 하나인 뷰티르산 증가를 통한 신경세포 보호효과를 나타내었다. 또한, 알츠하이머병과 파킨슨병에서 뇌-혈관장벽의 기능이상이 밝혀졌으며, 뇌-혈관장벽 변화는 장내미생물 불균형에 의한 전신성 염증에 따른 미세소관의 파괴 및 투과성 증가와 연관된 것으로 나타났다. 더불어 장내미생물 대사과정에서 생성된 대사산물은 퇴행성 뇌질환의 발생과 치료에 영향을 미친다. 본 논문에서는 인지기능 저하의 진행을 지연시킴으로써 심화를 방지할 수 있는 효과적인 접근법을 제시하기 위하여 인지기능 저하와 장내미생물의 연관성을 심층적으로 고찰하여 치료적 대안으로 제시하고자 한다.

• 동서간호학연구지
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• 제30권1호
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• pp.31-41
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• 2024

Purpose: This study aimed to identify factors affecting subjective cognitive decline (SCD) in men and women. Methods: This study was conducted based on data from the 2021 Korea Community Health Survey, and targeted a total of 80,026 men and 98,753 women aged 40 or older who responded to the SCD assessment. Multivariate logistic regression analysis using a complex sample was performed to identify factors influencing SCD. Results: Of the participants, 19,438 (22.7%) men and 30,826 (29.9%) women in the community reported SCD. Significant factors that influence SCD in both groups were age, education level, subjective health status, and depressive symptoms, and the strongest risk factor was depressive symptoms. Compared to women, men's monthly income, flexibility exercise, hypertension, and diabetes mellitus were found to be significant factors on SCD and Healthcare services affected SCD only in women. Medical services affected SCD only in women. Conclusions: When planning and providing intervention programs for cognitive function, it is necessary to reflect differences in factors associated with SCD according to sex.

• 한국식품과학회지
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• 제53권3호
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• pp.278-289
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• 2021

본 연구는 인지기능 개선에 도움이 되는 천연기능성소재를 선발하기 위해 체계적 문헌고찰을 실시하였다. 2020년 10월 06일 기준 문헌검색을 통해 16,184건을 수집하였고 선택 및 배제 기준에 따라 총 27건의 문헌을 선별하였다. 27건 중 ω-3 지방산 관련 논문 12건, 비타민 B군 관련 논문 8건, 비타민 D와 E 관련 논문 각각 1건이었으며, 안세린/카르노신, 베테인, 카페인, 크로뮴, 피소스티그민 관련 논문이 각각 1건이었다. 각 문헌의 비뚤림 위험 평가를 진행한 결과 ω-3 지방산 관련 논문 2건, 비타민 B군 관련 논문 1건, 베테인, 카페인, 피소스티그민 관련 논문의 비뚤림 위험이 '높음'으로 평가되었고, 비뚤림 위험이 높다고 평가된 6건의 논문들을 제외하고 근거수준평가 및 결과분석을 시행하였다. ω-3 지방산 관련 논문은 6-24개월동안 DHA 0.48-2.2 g, EPA 203-720 mg의 용량을 함께 또는 따로 중재하여 총 1,031명의 대상자 중 437명의 유의적인 효과를 확인하였다. 경도인지장애 환자를 대상으로 진행된 ω-3 지방산 논문에서는 인지기능영역(공간력, 기억력, 회상력, 언어력)과 인지기능 관련 바이오마커(Aβ-42, APP mRNA)를 개선시키는 등 치매개선에 긍정적인 효과를 나타냈다. 그러나 치매 환자를 대상으로 한 ω-3 지방산 연구에서는 인지기능평가에 대한 개선효과를 확인하기 어려웠다. 비타민 B 관련 논문은 6 또는 24개월 동안 엽산 400-800 ㎍, 비타민 B₁₂ 25-500 ㎍, 비타민 B₆ 20 mg의 용량을 함께 또는 따로 중재하여 총 1,180명의 대상자 중 530명에서 유의적인 효과를 확인하였다. 비타민 B군의 섭취는 치매 위험성과 관련된 혈중 호모시스테인 농도를 감소시켰으며, 혈중 ω-3 지방산의 농도와 높은 상관관계를 나타내는 것을 확인할 수 있었다. 그 외에 비타민 D와 E는 인지기능관련 바이오마커(Aβ-42, APP mRNA, PS1 mRNA)를 감소시키고 인지기능평가(WAIS-RC, ADAS-cog) 개선효과를 나타냈으며 안세린/카르노신은 치매척도검사를 개선하였고 크로뮴 섭취는 기억력 부분의 인지기능영역을 유의적으로 개선하였다. 그러나 ω-3 지방산과 비타민 B를 제외한 연구들은 선별된 문헌의 개수가 제한적이며, 개선 효과를 판단할 근거가 부족하였다. 중재 기간 및 용량에 따라 결과를 종합하면, ω-3 지방산은 6개월 이상 DHA 0.48-2.2 g, EPA 203-720 mg의 용량을 복합 또는 DHA 단독으로 중재했을 경우 인지기능 개선 효과를 확인할 수 있었으며, 엽산 400-800 ㎍, 비타민 B₁₂ 25-500 ㎍, 비타민 B₆ 20 mg의 용량을 복합 또는 엽산을 단독으로 6개월 이상 중재할 경우 혈중 호모시스테인 농도 감소와 인지능력개선을 확인할 수 있었다.

• Journal of Ginseng Research
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• 제48권3호
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• pp.245-252
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• 2024

Ginseng is a traditional herbal medicine used for prevention and treatment of various diseases as a tonic. Recent scientific cohort studies on life prolongation with ginseng consumption support this record, as those who consumed ginseng for more than 5 years had reduced mortality and cognitive decline compared to those who did not. Clinical studies have also shown that acute or long-term intake of ginseng total extract improves acute working memory performance or cognitive function in healthy individuals and those with subjective memory impairment (SMI), mild cognitive impairment (MCI), or early Alzheimer's disease (AD) dementia who are taking AD medication(s). Ginseng contains various components ranging from classical ginsenosides and polysaccharides to more recently described gintonin. However, it is unclear which ginseng component(s) might be the main candidate that contribute to memory or cognitive improvements or prevent cognitive decline in older individuals. This review describes recent clinical contributors to ginseng components in clinical tests and introduces emerging evidence that ginseng components could be novel candidates for cognitive improvement in older individuals, as ginseng components improve SMI cognition and exhibits add-on effects when coadministered with early AD dementia drugs. The mechanism behind the beneficial effects of ginseng components and how it improves cognition are presented. Additionally, this review shows how ginseng components can contribute to SMI, MCI, or early AD dementia when used as a supplementary food and/or medicine, and proposes a novel combination therapy of current AD medicines with ginseng component(s).

• 대한영상의학회지
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• 제85권1호
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• pp.184-196
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• 2024

목적 인지기능 저하를 진단하기 위해서 자기공명영상을 이용한 영상 소견의 진단능을 평가하였다. 대상과 방법 총 138명의 주관적인 인기지능 저하를 호소하며, MRI 검사를 시행한 환자를 대상으로 하였다. 이 환자 그룹은 신경정신학적 평가를 통해 알츠하이머군과 비알츠하이머군으로 분류되었다. 우리는 이들의 white matter hyperintensity와 cerebral microbleed를 평가하였으며, Kruskal- Wallis test를 통해 그룹 간의 비교를, receiver operating characteristic (이하 ROC)를 통해 영상학적 소견의 진단능을 평가하였다. 결과 인지기능 정상인 경우와 경도인지장애 환자와 비교해서 알츠하이머 환자에서 엽 혹은 심부 미세출혈이 빈번하게 관찰되었으며, 심한 심부 혹은 뇌실주위, 전체 백질 신호강도 또한 인지기능 정상에 비해서 알츠하이머 환자에서 많이 관찰되었다. 알츠하이머 환자와 다른 환자 그룹(정상 혹은 경도인지장애)을 비교할 때 엽미세출혈과 뇌실주위 뇌백질 신호강도 증가가 같이 존재하는 경우 가장 높은 진단능을 보였다(area under the ROC curve = 0.702[95% 신뢰구간: 0.599-0.806], p < 0.001). 결론 자기공명영상에서 확인한 영상 소견을 바탕으로 인지기능 저하의 진단능을 평가하였다. 인지기능 저하의 진단에 있어서 엽미세출혈과 뇌실주위 뇌백질 신호강도 증가가 같이 존재하는 경우에 높은 진단능을 보였으며, 이러한 소견을 바탕으로 인지기능 저하를 진단하는 데 있어 영상 소견이 도움을 줄 수 있을 것이라는 가능성을 보여주었다.

• 아동학회지
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• 제23권1호
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• pp.71-85
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• 2002

This study examined the effects of different interaction styles, that is, interaction with an object and interaction with an adult, on young children's cognitive level. Subjects were 150 5-year-old children. The task required children to predict the working of a mathematical balance beam. Seven cognitive levels were identified based on the logic of prediction. Data were analyzed by t-test, F-test, Duncan Test and Wilcoxon Matched-Pairs Test. Results showed that both interaction styles caused improvement in children's cognitive level, but when interaction with an adult was divided into two categories, i.e., interaction with the higher group and interaction with the lower group, the latter experienced decline in cognitive level. Regardless of sex, interactions within the Zone of Proximal Development and with the object were found to be effective methods for children's cognitive improvement.

• 보건교육건강증진학회지
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• 제32권3호
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• pp.109-120
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• 2015

Objectives: The purpose of this study was to investigate risk factors for chronic ADL, IADL disability. The study explored clinical and socio-demographic risk factors of functional status decline. Methods: Data from the Survey of Living Condition of Elderly 3-year panel study were analyzed. The study subjects were 5,928 community-dwelling people aged 65 years or older who were no disability in ADL and IADL at baseline. Predisposing factors, pathology, impairment, and functional limitations were regarded as risk factors. Logistic regression analysis was used. Results: During the 3-year study period, 3.9% participants developed chronic ADL disability, 9.4% participants were IADL disabled. After controlling for predisposing factor, the best predictors for ADL disability at 36 months were fall as a pathology factor, cognitive decline, disability judgement, lower limb functional limitation. Comorbidity, fall, cognitive decline, disability judgement, lower limb and upper limb functional limitation were risk factors for IADL disability. Conclusions: Health promotion program focusing elderly is essential to prevent ADL and IADL disability. Mobilizing physical activity should be included in health promotion program for elderly.

• 생물정신의학
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• 제23권4호
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• pp.199-204
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• 2016

Objectives Although forgetfulness is a common complaint among menopausal depressed women, there is still a debate about the relationship between memory impairment and menopause. The aim of this study is to examine whether menopause is related to cognitive decline among women with depressive disorders. We hypothesized that postmenopausal depressed women show generally poorer performance than premenopausal depressed women on various cognitive function tests. Methods With a retrospective chart review, we identified a total of 87 female patients (45 premenopausal patients and 42 postmenopausal patients) who were hospitalized with depressive disorders from 2000 to 2016. Demographic and clinical variables and cognitive test results were compared between two groups. Results Education year is longer in premenopausal group than postmenopausal group whereas clinical characteristics (illness duration, recurrence, and symptom severity) and mean Intelligence Quotient (IQ) were similar between two groups. The postmenopausal group took longer time for Bender-Gestalt Test (BGT) recall, Trail Making Test (TMT)-A, and TMT-B than the premenopausal group. After controlling for age and education, significant difference was remained for BGT recall (p = 0.029). Conclusions Postmenopausal state may be related with decline of visuospatial memory function, in particular, among depressed female patients. Other areas of cognitive function including complex attention, verbal memory, auditory memory, and working memory might be interpreted while considering age and education level.

• Nutrition Research and Practice
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• 제16권5호
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• pp.673-684
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• 2022

BACKGROUND/OBJECTIVES: Although adherence to a higher diet quality may help prevent cognitive decline in older adults, literature for this in a Korean population is limited. Thus, the aim of this study was to examine the association between diet quality indices and the risk of mild cognitive impairment (MCI) in Korean older adults. SUBJECTS/METHODS: This cross-sectional study included 806 community-dwelling people aged 60 yrs and over in Korea. Diet quality was assessed via the revised Recommended Food Score (RFS) and alternate Mediterranean Diet Score (aMDS). Cognitive function was measured using a Korean version of the Mini-Mental State Examination (MMSE-KC). Associations between diet quality indices and MMSE-KC score were assessed with a general linear model after adjusting for covariates. Logistic regression was used to determine the association between diet quality indices and the risk of MCI. RESULTS: The prevalence of MCI was 35.3%. There were no significant trends between MMSE-KC scores and RFS and aMDS after adjusting for age, gender, education, exercise, living status, social activity, and alcohol drinking. Among total subjects, RFS was inversely associated with the risk of MCI after adjusting for covariates (Q5 vs. Q1; odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.83). Among total subjects and men, aMDS was inversely related to the risk of MCI after adjusting for covariates (Q5 vs. Q1; OR, 0.51; 95% CI, 0.29-0.89 for total subjects; Q5 vs. Q1; OR, 0.36; 95% CI, 0.15-0.83 for men). CONCLUSIONS: Our results demonstrate that high diet quality evaluated by RFS and aMDS is inversely associated with the risk of MCI. Thus, high quality diet may reduce or retard cognitive decline in the old population. Longitudinal studies are needed to determine the causal relationship between diet quality and the risk of MCI in the elderly.