• Journal of The Korean Society of Integrative Medicine
• /
• v.9 no.3
• /
• pp.37-45
• /
• 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.

• Therapeutic Science for Rehabilitation
• /
• v.11 no.2
• /
• pp.53-62
• /
• 2022

Objective : This study aimed to present basic data that could help in selecting or using evaluation tools in clinical settings. Methods : This study included 51 patients with stroke. The Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2), and Clinical Dementia Rating (CDR) were used as evaluation tools. The correlation between evaluation tool scores was analyzed using Spearman's rank correlation coefficient, and the comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores was analyzed using the Wilcoxon signed-rank test. Results : The correlation between the total CIST and K-MMSE~2 scores and global CDR scores was statistically significant (p<.01). The correlation between the sub-scores of the CIST and K-MMSE~2 showed a statistically significant correlation for all sub-scores (p<.01). The comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores showed no statistically significant differences in all global CDR scores. Conclusion : This study showed that there was a correlation between CIST, K-MMSE~2, and CDR in patients with stroke. In the future, we hope that the results of this study will help to select or use cognitive function evaluation tools in clinical settings.

• Dementia and Neurocognitive Disorders
• /
• v.23 no.3
• /
• pp.117-126
• /
• 2024

Background and Purpose: The Korean-Mini Mental State Examination, 2nd edition (K-MMSE~2) was recently released. This study aimed to determine whether the K-MMSE~2: Standard Version (K-MMSE~2:SV) had the same test characteristics as the K-MMSE. Methods: A total of 1,514 healthy community-based participants aged 19 to 90 years were administered the K-MMSE~2:SV Blue Form along with the language items from the K-MMSE. The item and test characteristics and test information for the K-MMSE~2:SV and K-MMSE were compared using Item Response Theory analysis. Results: Item discriminations for the K-MMSE~2:SV and K-MMSE were above the moderate range for all items except Recall. Most of the items on the K-MMSE~2:SV and K-MMSE had item category difficulty in the very easy or easy range. The test information curve (TIC) showed that the K-MMSE~2:SV and K-MMSE provide almost the same amount of information (27.86 vs. 28.44), with both tests providing the most information at an ability level of -1.57. The generalizability (G) coefficient for the K-MMSE~2:SV and K-MMSE was 0.99. Conclusions: These results indicate that the K-MMSE~2:SV and K-MMSE are equally optimal tests for screening for mild cognitive impairment and early dementia. Given that the amount of test information provided by the two tests was almost identical, the shapes of the TICs were very similar, and the G coefficient was close to 1, we can conclude that the K-MMSE and K-MMSE~2:SV are equivalent tests.

• Journal of Society of Occupational Therapy for the Aged and Dementia
• /
• v.12 no.2
• /
• pp.107-115
• /
• 2018

Objective : The purpose of this study is to investigate the effect of a group occupational therapy program on the depression and quality of life of the elderly with Mild Cognitive Impairment(MCI). Method : The elderly with Mild Cognitive Impairment were selected based on the Mini Mental State Examination-Dementia Screening(MMSE-DS). The group occupatinal therapy program consisted of various cognitive domains and was performed 12 times for 6 weeks. The Geriatric Depression Scale(SGDS-K) and Quality of Life(QOL) were used to assess depression and quality of life of the subjects before and after the intervention. Result : The elderly with MCI improved significantly on the SGDS-K and QOL after the intervention program(p<0.05). Particularly, in some items of the QOL, there was a statistically significant difference, but the results of the SGDS-K and QOL did not show any correlation(p>0.05). Conclusion : In the case of the elderly with MCI, the QOL scale and the depressive symptom test were statistically significant when the group occupational therapy program was applied for 6 weeks.

• Research in Community and Public Health Nursing
• /
• v.27 no.1
• /
• pp.1-8
• /
• 2016

Purpose: The purpose of this study was to examine the depression and cognitive function of community-dwelling older adults. Methods: 243 aged over 65 in Won-Ju in South Korea participated in this study. Data were collected from April to June 2013 through interviews. This study utilized the Geriatric Depression Scale Short Form, the Korean version of MMSE-DS (MMSE for Dementia Screening), and infirmity testing for basic health status. Descriptive statistics, ${\chi}^2$, t-test, ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, and Pearson's correlation coefficient were used. Results: 75.3% of the participants belonged to the depression group, and the prevalence of cognitive impairment was 17.3%. There were significant differences in depression and cognitive function according to gender, educational level, type of insurance, subjective health, frailty, and whether to be a client of home care service. The level of depression was significantly higher and the level of cognitive functions was significantly lower in older adults in home care services than in community-dwelling older adults. Conclusion: This study is meaningful in that it included older adults in home care services to provide information to develop effective prevention programs for improving cognitive functions. The results of this study can be used to develop future community prevention and intervention.

• Dementia and Neurocognitive Disorders
• /
• v.21 no.1
• /
• pp.17-29
• /
• 2022

Background and Purpose: Verbal and nonverbal fluency tests are the conventional methods for examining executive function in the elderly population. However, differences in impairments result in fluency tests in patients with mild cognitive impairments (MCIs) and Alzheimer's disease (AD) and in neural correlates underlying the tests still necessitate concrete evidence. Methods: We compared the test performances in 27 normal controls, 28 patients with MCI, and 20 with AD, and investigated morphological changes in association with the test performances using structural magnetic imaging. Results: Patients with AD performed poorly across all the fluency tests, and a receiver operating characteristics curve analysis revealed that only category fluency test discriminated all the 3 groups. Association, category, and design fluency tests involved temporal and frontal regions, while letter fluency involved the cerebellum and caudate. Conclusions: Category fluency is a reliable measure for screening patients with AD and MCI, and this efficacy might be related to morphological correlates that underlie semantic and executive processing.

• The Journal of the Korea Contents Association
• /
• v.13 no.12
• /
• pp.321-327
• /
• 2013

Impaired naming difficulty is common in normal elderly as well as in patients with neurological impairment. The 60-item Korean version-Boston Naming Test(K-BNT) is one of the most commonly used test for measuring confrontational naming ability. However, age-related cognitive decline may make the elderly difficult concentrating during the 60-item test, therefore, item reduction of the K-BNT would improve test validity and reliability. Thus, the purpose of this study was to develop a short form of the K-BNT based on Item Response Theory(IRT). Considering item-fit index, sex factor, and item difficulty through Rasch analysis, the 15-item K-BNT(i.e., K-BNT-15) was developed. Via administration of the K-BNT-15, we observed age-related decline in naming ability and significantly different performance between the normal elderly and patients with mild cognitive impairment. This study demonstrates the utility of IRT for developing a short-form language evaluation tool. The K-BNT-15 can be effective as a language screening tool to differentiate between normal aging and pathological diseases.

• Nutrition Research and Practice
• /
• v.17 no.2
• /
• pp.371-385
• /
• 2023

BACKGROUND/OBJECTIVES: Soy isoflavone (SIF) and soy lecithin (SL) have beneficial effects on many chronic diseases, including neurodegenerative diseases. Regretfully, there is little evidence to show the combined effects of these soy extractives on the impairment of cognition and abnormal cerebral blood flow (CBF). This study examined the optimal combination dose of SIF + SL to provide evidence for improving CBF and protecting cerebrovascular endothelial cells. MATERIALS/METHODS: In vivo study, SIF50 + SL40, SIF50 + SL80 and SIF50 + SL160 groups were obtained. Morris water maze, laser speckle contrast imaging (LSCI), and hematoxylin-eosin staining were used to detect learning and memory impairment, CBF, and damage to the cerebrovascular tissue in rat. The 8-hydroxy-2'-deoxyguanosine (8-OHdG) and the oxidized glutathione (GSSG) were detected. The anti-oxidative damage index of superoxide dismutase (SOD) and glutathione (GSH) in the serum of an animal model was also tested. In vitro study, an immortalized mouse brain endothelial cell line (bEND.3 cells) was used to confirm the cerebrovascular endothelial cell protection of SIF + SL. In this study, 50 µM of Gen were used, while the 25, 50, or 100 µM of SL for different incubation times were selected first. The intracellular levels of 8-OHdG, SOD, GSH, and GSSG were also detected in the cells. RESULTS: In vivo study, SIF + SL could increase the target crossing times significantly and shorten the total swimming distance of rats. The CBF in the rats of the SIF50 + SL40 group and SIF50 + SL160 group was enhanced. Pathological changes, such as attenuation of the endothelium in cerebral vessels were much less in the SIF50 + SL40 group and SIF50 + SL160 group. The 8-OHdG was reduced in the SIF50 + SL40 group. The GSSG showed a significant decrease in all SIF + SL pretreatment groups, but the GSH showed an opposite result. SOD was upregulated by SIF + SL pretreatment. Different combinations of Genistein (Gen)+SL, the secondary proof of health benefits found in vivo study, showed they have effective anti-oxidation and less side reaction on protecting cerebrovascular endothelial cell. SIF50 + SL40 in rats experiment and Gen50 + SL25 in cell test were the optimum joint doses on alleviating cognitive impairment and regulating CBF through protecting cerebrovascular tissue by its antioxidant activity. CONCLUSIONS: SIF+SL could significantly prevent cognitive defect induced by β-Amyloid through regulating CBF. This kind of effect might be attributed to its antioxidant activity on protecting cerebral vessels.

• Journal of The Korean Society of Integrative Medicine
• /
• v.12 no.2
• /
• pp.111-119
• /
• 2024

Purpose : This study aimed to demonstrate the effects of visiting cognitive activities using brain training on cognition, subjective memory complaints and depression among elderly participants residing in community living in Gwangmyeong city. Methods : Over a 14-month period (October 2022 to December 2023), four brain training instructors visited the homes of older adults and conducted the intervention using a brain training kit. The participants included 32 elderly individuals aged 65 years and older, who were living in Gwangmyeong city. The assessments were conducted by an occupational therapist, a nurse and a social worker at the Gwangmyeong dementia relief center. These assessments included the following the subjective memory complaints questionnaire (SMCQ), short geriatric depression scale-Korean (SGDS-K), a cognitive impairment screening test (CIST), the consortium to establish a registry for Alzheimer's disease-Korean (CERAD-K). The participants were divided into three groups (A: 20-30 points, B: 10-19 points, C: 1-9 points) based on the CIST score. For data analysis, descriptive statistics and wilcoxon signed-rank test were performed using SPSS 24.0, and the statistical level was at a=.05. Results : The results of the intervention showed that the SMCQ score of group A improved significantly (p<.05), the CIST score of group B also improved significantly (p<.05). However, the SGDS-K score of group C improved, but did not demonstrate statistical significance (p=.080). Conclusion : The visiting cognitive activities using brain training produced significant effects on cognition, depression, and subjective memory disorders, depending on the cognitive level of the elderly participants. In the future, it will be necessary to demonstrate the effects according to cognitive level in various aspects with more elderly people.

• Therapeutic Science for Rehabilitation
• /
• v.8 no.3
• /
• pp.43-55
• /
• 2019

Objective: The purpose of this study is to conduct a preliminary research for the development of a Performance-Based Cognitive Function Test (PCFT) to screen the elderly for cognitive function impairment, and examine the reliability and validity of the test. Methods: A draft version of the Performance-Based Cognitive Function Test (PCFT) was developed and utilized in nine healthy elderly individuals. In order to verify its reliability, we analyzed the internal consistency of the PCFT. In order to verify the concurrent validity of the PCFT, this study analyzed the correlation between motor-cognitive dual task assessments and the Korean version of the Mini-Mental State Examination (MMSE-K). Results: The internal consistency of the PCFT for motor and cognitive tasks was 0.871 and 0.959 (Cronbach's ${\alpha}$), respectively. Concurrent validity of the PCFT, which was performed through motor-cognitive dual task assessments, ranged from 0.755 to 0.964 (Spearman's rho statistic, p < 0.05). In addition, correlation between the cognitive assessment tool and the MMSE-K ranged from 0.849 to 0.943 (p < 0.01). Conclusion: This study verified, and established the reliability and validity of the PCFT. Further studies are required to examine other psychometric properties in a modified PCFT, for screening cognitive function impairments in the elderly.