• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.183-191
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• 2019

Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.1
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• pp.50-58
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• 2012

Objectives : This study examined the selective deficits of executive function in patients with mild traumatic brain injury that in normal range of general intelligence level and aimed to analysis of the correlation between K-WAIS result and executive function. Methods : 59 subjects were included in this study, who were diagnosed as mild traumatic brain injury(MTBI) and they have visited in neuropsychiatric department of Wonkwang University Hospital during from March, 2005 to September, 2010. For measurement of general intelligence quotient, the Korean-Wechsler Adults Intelligence Scale(K-WAIS) was administered and for measurement of executive intelligence quotient(EIQ), Executive Intelligence Test(EXIT) was administered. Results : Of patients, 50.8% included at abnormal EIQ group. The patients of abnormal EIQ showed poorer full scale IQ(FIQ), performance IQ(PIQ) and in subscale that picture arrangement, digit symbol, digit span, block design, object assembly and comprehension were significantly different. In terms of relationships between K-WAIS and EIQ, FIQ and PIQ have positive correlation with EIQ. And in subscale, picture arrangement, digit symbol, digit span, block design, object assembly and comprehension show positive correlation with EIQ. Conclusion : This study suggest that MTBI patients with have normal range of general intelligence level may have deficit of executive function is common. The decline of FIQ, PIQ and some subscales of K-WAIS may suggest executive dysfunction in MTBI patients.

• Perspectives in Nursing Science
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• v.9 no.1
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• pp.45-50
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• 2012

Purpose: Despite poor cognitive function in heart failure (HF), few studies have examined cognition and its probable implication in self-care among Korean HF patients. The purposes of this study were (1) to describe cognition in the domains of global, memory, and executive functions, (2) to explore the relationship between cognition and self-care, and (3) to determine the amount of dietary sodium intake among Korean HF patients. Methods: A pilot study was conducted: 7 HF patients (3 men, mean age 68 years) completed face-to-face interviews for neuropsychological tests of cognition and self-care including dietary sodium intake. Results: More than half of the patients had impaired global cognition, memory, or executive function; patients with more severe HF were at higher risk of poor cognitive function. Korean HF patients exhibited poor self-care, with a high dietary sodium intake (5.6 g/day), approximately twice more than the suggested guideline of 2~3 g/day for patients with stable HF. Conclusion: Cognitive dysfunction and inadequate self-care with noncompliance with dietary sodium restriction were evident in Korean HF patients. More studies are warranted that examine the prevalence of cognitive impairment and areas of deficit using neuropsychological tests in a larger sample and that examine how cognition affects self-care and compliance in salt-intake.

• Journal of Digital Convergence
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• v.20 no.3
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• pp.517-527
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• 2022

This study aimed to compare changes in cognitive function, depression and ability to perform activity of daily living (ADL) in patients with dementia, mild cognitive impairment (MCI), and ischemic stroke (IS) and to identify factors associated with changes in instrumental ADL. A total of 86 patients (dementia=30, MCI=32, and IS=24) were included to analyse cognitive function, depression, and basic and instrumental ADL obtained at the time of diagnosis and 1 year after baseline. Repeated measures analysis of variance and multiple linear regression were used. A significant group by time interaction was found in executive function (p=.037) and instrumental ADL (p=.023) across groups. The MCI group has little change in executive function and instrumental ADL from the baseline to 1 year after diagnosis while other two groups showed changes with the dementia group showing declines and the group of IS having improvement in these factors over time. Changes in executive function(p=.030) and basic ADL (p<.001) explained 26.9% in the variance of changes in instrumental ADL. These findings showed a different changing pattern in executive function during the first year after diagnosis of dementia, MCI, and IS which have cognitive changes as their main symptoms, probably leading to a different changing pattern in instrumental ADL. Healthcare professionals should routinely assess for executive function and instrumental ADL problems and intervene to maintain and improve these functional outcomes immediately after disease.

• Korean Journal of Biological Psychiatry
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• v.24 no.2
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• pp.75-81
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• 2017

Objectives Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. Methods Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. Results Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. Conclusions Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.207-218
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• 2013

Long term outcomes after liver transplantation are major determinants of quality of life and of the value of this heroic treatment. As short term outcomes are excellent, our community is turning to take a harder look at long term outcomes. The purpose of this paper is to review these outcomes, and highlight proposed treatments, as well as pressing topics needing to be studied. A systemic review of the English literature was carried in PubMed, covering all papers addressing long term outcomes in pediatric liver transplant from 2000-2013. Late outcomes after pediatric liver transplant affect the liver graft in the form of chronic liver dysfunction. The causes include rejection particularly humoral rejection, but also de novo autoimmune hepatitis, and recurrent disease. The metabolic syndrome is a major factor in long term cardiovascular complication risk. Secondary infections, kidney dysfunction and malignancy remain a reality of those patients. There is growing evidence of late cognitive and executive function delays affecting daily life productivity as well as likely adherence. Finally, despite a good health status, quality of life measures are comparable to those of children with chronic diseases. Long term outcomes are the new frontier in pediatric liver transplantation. Much is needed to improve graft survival, but also to avoid systemic morbidities from long term immunosuppression. Quality of life is a new inclusive measure that will require interventions and innovative approaches respectful not only on the patients but also of their social circle.

• 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 the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.217-231
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• 1997

This paper first reviewed the current neurological theories concerning the etiology of ADHD and secondly, examined results of studies that applied neuropsychological assessment methods in the examination of ADHD children both here in Korea and abroad. ADHD children were found to exhibit characteristic responses indicating deficits in vigilance, sustained attention, distractibility, allocation and regulation of attention in many assessments of attention, in addition to deficits in executive functioning, working and associative memory. Such neuropsychological assessment results suggest that in addition to dysfunction in the frontal lobe and the reticular activation system, dysfunction may exist in other neural pathways involving many areas of the brain. However, because a substantial number of neuropsychological assessment tools being employed in Korea for ADHD children had been developed abroad, a Korean standardization project involving ADHD and normal control children, in addition to other child psychiatric population pools must be conducted in order to obtain appropriate age norms and test validity, and in order to make possible a more accurate and precise comparison and interpretation in the assessment of ADHD children.

• Physical Therapy Korea
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• v.12 no.3
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• pp.67-73
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• 2005

Prospective memory (PM) is related to remember to carry out a previously intented behaviour. The purpose of this study was to develop a paradigm for measuring PM function to diagnosis in mild cognitive impairment 1 or brain injury in patients 2. among brain injured patients Thirty-eight normal healthy subjects participated in current study. The paradigm was composed of four conditions: a baseline and three intention conditions (expectation, execution 1 and 2). In the expectation condition, subjects were asked to make a new response to intented stimuli during ongoing task, but the intented stimuli never occurred. In the execution 1 (one type of expected stimulus) and 2 (two types of expected stimuli), the intended stimuli did occur in 20% of trials. The reaction time and error rate were calculated in each condition. Repeated measures using ANOVA of subject's mean reaction times (RTs) and mean error rates (ERs) showed main effects of conditions during ongoing task. The comparison of PM tasks in executive condition 1 and 2 also showed significance in RTs and ERs. This paradigm reflects sufficiently the performance of prospective memory function during ongoing task in normal individuals. Thus, we suggest that the paradigm will be helpful to study neural network of PM function using brain imaging techniques and diagnosis of PM dysfunction.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.493-502
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• 2021

Objective: Older adults with mild cognitive impairment (MCI) are more likely to progress to dementia. Motor-cognitive training is applied as a dual-task to improve the cognitive and physical functions of older adults with MCI. The purpose of the study was to know the recent trends in motor training types and outcome measures used for motor-cognitive training in older adults with MCI. Design: Aliterature review Methods: This literature review was conducted in Pubmed, MEDLINE® and Google Scholar with the following key words: older adults, mild cognitive impairment, motor-cognitive training, cognition, and dual-task. The 7 studies were found with the search tool and all studies were randomized controlled trials. Results: In motor-cognitive training in older adults with MCI, 6 studies applied aerobic exercise. And 3 out of 6 studies also applied strengthening exercises. One study applied dual tasks without aerobic exercise. In the 6 studies, overall cognitive and executive function were used as outcome measures, and physical function was evaluated as gait performance. Memory and physical frailty were also used as measurement tools. As a result of all studies, when motor-cognitive training was applied, cognition and physical performance showed significant results. Conclusions: A recent five-year study applied mainly aerobic exercise and strength training to older adults with MCI and found it to improve cognitive and physical performance.