• 생물정신의학
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• 제22권3호
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• pp.140-148
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• 2015

Objectives The aim of this study is to investigate the correlation between degenerative changes in brain [i.e., global cortical atrophy (GCA), medial temporal atrophy (MTA), white matter hyperintensities (WMH)] and neurocognitive dysfunction in Korean patients with Alzheimer's disease. Methods A total of 62 elderly subjects diagnosed with Alzheimer's disease were included in this study. The degenerative changes in brain MRI were rated with standardized visual rating scales (GCA or global cortical atrophy, MTA or medial temporal atrophy, and Fazekas scales) and the subjects were divided into two groups according to the degree of degeneration for each scale. Cognitive function was evaluated with Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) and several clinical features, including apolipoprotein E ${\varepsilon}4$ status, lipid profile and thyroid hormones, were also examined. Chi-square test and Fisher's exact test were performed to analyze the relationship between the degree of cerebral degeneration and neurocognitive functions. Results Demographic and clinical features, except for the age, did not show any significant difference between the two groups divided according to the degree of cerebral degenerative changes. However, higher degree of GCA was shown to be associated with poorer performance in verbal fluency test, word list recall test, and word list recognition test. Higher degree of MTA was shown to be associated with poorer performance in Mini-Mental State Examination in the Korean Version of CERAD Assessment Packet (MMSE-KC), word list recognition test and construction praxis recall test. Higher degree of white matter hyperintensities was shown to be associated with poorer performance in MMSE-KC. Conclusions Our results suggest that severe brain degeneration shown in MRI is associated with significantly poorer performance in neurocognitive tests in patients with Alzheimer's disease. Moreover, the degree of GCA, MTA and white matter hyperintensities, represented by scores from different visual rating scales, seems to affect certain neurocognitive domains each, which would provide useful information in clinical settings.

• 가정과삶의질연구
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• 제32권6호
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• pp.125-138
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• 2014

The purpose of this study is to examine the effects a music group therapy program has on cognitive function and life satisfaction. We targeted the elderly who are receiving service at a daycare center. This study monitored seventeen elderly subjects who were available for language communication, walking, and defecation function even if the subject had a slight mind-body function disorder based on using the service of the daycare facilities. The subjects visited each of the welfare centers one week prior to the Korean classical music group therapy program. We conducted a pre-test of MMSE-K(Mini-Mental State Examination, Korean version) modified by Park and Gwon(1989). We also supplemented the MMSE developed by Folstein(1975) and LSI-A(Life Satisfaction Index) for the elderly developed by Neugarten, Havighurst and Tobin(1961). We conducted the Korean classical music group therapy program for 15 sessions at 50 minutes each for 1~2 times a week from July 9 to September 13, 2013 at the daycare center for OO senior welfare center. The welfare center belongs to the experimental group, excluding the OO general welfare center, which is the control group. Finally, we carried out the post-test of the MMSE-K and LSI-A in the same manner as the pre-test. We carried out the post-test on July 17, 2013, 4 days after concluding the Korean classical music group therapy program. A t-test was used in order to analyze the differences in cognitive function and life satisfaction according to each group. We used SPSS/WIN 18.0 program. This study has significance by proving that the use of Korean classical music is conducive in the improvement of cognitive function and life satisfaction of the elderly at the daycare facilities. Also, we presented the actual contents of the study to the clinical field.

• 정신신체의학
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• 제26권1호
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• pp.59-67
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• 2018

연구목적 본 연구의 목적은 2형 당뇨병 환자에서 인지 장애의 빈도와 특성 및 이에 연관되는 변인과 위험 인자를 알아보기 위함이다. 방 법 2형 당뇨병 환자 80명(남성 42명, 여성 38명)을 대상으로 구조적 면담을 통해서 인구학적 및 임상적 정보를 얻었다. 한국판 간이 정신상태 평가(K-MMSE)와 한국판 몬트리올 인지평가(MoCA-K)를 사용해서 인지기능을 평가하였고, 한국판 Hamilton 우울증 평가 척도(K-HDRS)를 사용해서 우울증을 평가하였다. 결 과 1) MMSE-K 총점 24점 이하는 13.75%, MoCA-K 총점 22점 이하는 38.8%였다. 2) 2형 당뇨병 환자 중에서 인지 장애가 있는 군(N=31명)은 인지 장애가 없는 군(N=49명) 보다 MoCA-K 총점, 시공간/실행력, 주의력, 언어, 지연 회상력, 지남력 소검사 점수가 유의하게 낮았다(p<0.001). 3) 인지 장애가 있는 군과 인지 장애가 없는 군 간에는 연령, 교육 수준, 경제 상태, 체질량 지수, 당뇨병 이병 기간, K-HDRS 총점, MMSE-K 총점 및 MoCA-K 총점에서 유의한 차이가 있었다(p<0.05). 4) MoCA-K 총점은 연령, 교육 수준, 체질량 지수, 당뇨병의 가족력, 당뇨병의 이병 기간, K-HDRS 총점과 유의한 상관관계가 있었다(p<0.05). 5) 2형 당뇨병 환자에서 남성, 낮은 교육 수준, 높은 공복 혈당치, 우울증의 심한 정도는 유의하게 인지 장애의 위험을 증가시킨다. 결 론 2형 당뇨병 환자의 인지 장애는 복합적인 여러 요인이 관계되는 것으로 생각된다. 따라서 이들의 진단과 치료에는 생물 심리 사회학적인 관점이 망라된 좀 더 포괄적인 접근이 요청된다.

• 말소리와 음성과학
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• 제2권4호
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• pp.75-82
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• 2010

Many previous studies based on respiratory characteristics of Idiopathic Parkinson's Diseases (IPD) patients have not controlled related factors appropriately. Accordingly, these studies produced discordant results. Furthermore, there is currently a lack of studies that can provide precise explanations on the characteristics of respiration and phonation. This study included a total of 40 subjects: 20 mixed gender de novo IPD patients ranging in age from 50 to 80 (Hoehn & Yahr stage 1~3), and 20 normal subjects with similar matches for age and gender. All participants were controlled based on their gender, age, height, weight, vocal fold function, cognitive abilities, and depression factors. K-MMSE (Korean-Mini Mental State Examination), nVHI-10 (new Voice Handicap Index), and KGDS (Korean Form of Geriatric Depression Scale) were evaluated to select this study subjects. In order to compare respiratory functions between the two groups, FVC, FEV1, and FEV1/FVC were measured using microQuark, a PC-based spirometer. CSL was used by measure MPT and PAS was used to measure MFR. To investigate the characteristics of phonation ability, CSL was used to measure jitter and shimmer, while PAS was used to measure Psub. In order to compare the respiratory function averages and phonation ability between the two groups, statistical analysis was conducted using SPSS (version 12.0). The results of this study showed that most de novo IPD patients were included in the normal average range of respiratory and phonatory ability. But the respiratory and phonatory ability of de novo IPD patients showed lower tendency as compared with the normal group. When the average of respiratory and phonatory ability among the gender was compared, the difference of males was greater than the difference of females.

• 한방재활의학과학회지
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• 제23권3호
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• pp.117-124
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• 2013

Objectives The aims of this study was to observe the effectiveness of East-West Integrative Medicine (EWIM) by analysing between EWIM estimated group and Non-EWIM eastimated group with Brain Rehabilitation Registry. Methods We divided hospitals into two groups, one is EWIM estimated group hospital (Kyeonghee university, Wonkwang university, Dongguk university) and the other is non-EWIM estimated group (Jeonnam university, Gyeongbuk university, Catholic university). Then we analysed the effectiveness of treatments retrospectively using the database of Brain Rehabilitation Registry (http://www.kbrr.or.kr/, version 1.0). Totally 293 patients were included, EWIM estimated group was 175 and non-EWIM estimated group was 118. The main outcome measurements were National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI) and Mini Mental State Examination-Korea (MMSE-K). Results Changes of NIHSS was not significant in both total patient and patient who treated over 3 weeks. MMSE-K showed positively significant difference (p=0.044) in EWIM estimated group patients who treated over 3 weeks. In case of MBI, EWIM estimated group showed more effective result and also statistically significant in both total patients and patients who treated over 3 weeks. Conclusions We patially argued that EWIM estimated group was more effective than non-EWIM estimated group in stroke patients' functional recovery. We suggested base data of EWIM in stroke patiens through this study and this could be applied future researches of developing modified EWIM system.

• 한국산학기술학회논문지
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• 제19권4호
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• pp.472-480
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• 2018

본 연구는 경도와 중등도 치매 환자의 인지 기능과 작업 참여 능력을 알아보고, 인지 기능과 작업 참여의 상관관계를 알아보고자 시행하였다. 2017년 9월부터 2017년 11월까지 대구광역시 지역의 주간보호센터를 방문하는 95명의 치매 환자를 대상으로 하였다. 인지 기능을 측정하기 위하여 한국판 간이정신상태 판별검사(MMSE-K)와 한국판 로웬스타인 작업치료 인지 평가-노인용(Loewenstein Occupational Therapy Cognitive Assessment Geriatric population: (LOTCA-G)을 사용, 작업 참여를 측정하기 위하여 인간작업모델 선별 평가도구(MOHOST)를 사용하였다. 본 연구 결과는 SPSS 20.0 통계처리 프로그램의 기술 통계를 이용하여 연구 대상자의 인지 기능과 작업 참여 정도를 분석하였고, 인지 기능과 작업 참여 간 상관관계 분석을 위해 피어슨 상관분석을 실시하였다. 연구 결과 치매 환자의 인지 기능과 작업 참여 간 상관관계를 확인할 수 있었다. 본 연구의 결과를 바탕으로 치매 환자의 평가 및 치료적 목표 수립 시 인지 기능과 관련한 작업 참여도 고려해야 할 것으로 사료된다.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.159-166
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• 2018

Objectives: The aim of this study was to investigate the association between masticatory ability, oral health-related quality of life, and cognitive function in an elderly population using structural equation modeling. Methods: A total of 308 subjects, aged 65 years and over, were recruited from the senior citizen center in Daegu, South Korea and provided consent for inclusion in the study. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to assess the level of cognitive function. Masticatory ability was evaluated through chewing tests, patient-perceived masticatory function and, measurement of relative occlusal forces on molar teeth using the T-Scan $III^{(R)}$ system. All data were analyzed using ${\chi}^2$ tests, t-tests, and one-way ANOVA in SPSS version 23.0 for windows. Structural equation modeling was performed using SPSS AMOS version 22.0. Results: There was a significant association between cognitive function and molar teeth occlusal force. Ability of food chewing score and patient-perceived masticatory function could affect oral health-related quality of life (P>0.05). Higher occlusal forces on molar teeth, compared to anterior teeth, positively correlated with higher cognitive function. Conclusions: These results suggest that an individual's oral health condition could affect molar teeth occlusal forces and may be related to a risk of developing dementia. Therefore, there is a need for implementing nation-wide policies to improve oral health, such as masticatory function, in the elderly population.

• 한국임상약학회지
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• 제29권4호
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• pp.238-246
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• 2019

Background: In South Korea, as an aged society, an understanding of dementia and its risk factors is important from clinical and healthcare policy perspectives. Relationship between cognitive impairment and body weight or weight changes have been reported, but these were contradictory. We have evaluated the association between weight changes and cognitive decline using national level longitudinal data. Methods: Data from the Korean Longitudinal Study of Ageing from 2006 to 2012 were used. Association between weight changes and decline in cognitive function as measured by K-MMSE (the Korean version of the Mini-mental state examination) score was assessed by multivariate logistic regression. Weight changes were calculated from 1st wave and 3rd wave survey data, and classified into five groups as stable, increases, decreases of >10%, or 5%-10%. Results: About 37% of the total participants (n=4,512) were 65 years or older. These participants made up the largest proportion of the groups with weight change exceeding 10%. Multivariate logistic regression analyses revealed that weight changes exceeding 10% (10% increase vs stable, adjusted OR [aOR] 1.47, 95% confidence interval (CI) 1.11-1.95; 10% decrease vs stable, aOR 1.44, 95% CI 1.11-1.88) were significant predictive factors for decline in cognitive function. In subgroup analyses, the association between weight changes and cognitive decline was significant in males aged over 65 years and in normal BMI groups. Conclusion: Weight changes, both increases and decreases exceeding 10% of baseline, were significantly associated with declines in cognitive function among older adults in South Korea.

• 대한지역사회작업치료학회지
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• 제2권1호
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• pp.49-63
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• 2012

목적 : 본 연구는 한국형 전산화 인지재활 프로그램인 코드라스(CoTras)가 뇌졸중 환자의 시지각 기능 및 일상생활동작 수행능력에 미치는 효과를 알아보고자 실시되었다. 연구방법 : 재활전문 C 요양병원에 거주하고 있는 뇌졸중 환자 14명을 대상으로 실험 전과 후를 측정하였다. 처치 전 후 시지각 기능의 변화를 알아보기 위하여 사용한 시지각 평가도구는 비운동성 시지각 평가를 사용하였고 일상생활동작 수행능력을 알아보기 위하여 Fisher(1999)에 의해 개발된 운동 및 처리기술 평가도구를 이용하여 일상생활수행능력을 평가하였다. 전산화 인지재활 프로그램 전과 후를 측정하였으며, 수집된 자료는 SPSS 15.0 통계프로그램을 사용하여 분석하였다. 연구대상자의 치료 전과 후의 시지각 기능 및 일상생활동작 수행능력의 효과를 알아보기 위하여 짝비교(Paired t-test)를 이용하여 분석하였다. 연구결과 : 첫째, 코트라스(CoTras)치료 전과 후의 시지각 기능의 차이를 짝비교(Paired t-test)를 이용해 분석한 결과, 통계학적으로 유의한 차이가 있었다(0.000, p <.05). 둘째, AMPS 운동기술 평균점수는 0.90에서 1.11으로 증가되었으나 통계학적으로 유의한 차이는 없었다. 처리기술 평균점수는 0.08에서 0.46점으로 증가되었으나 통계학적으로 유의한 차이가 없었고, 임상적으로 유의하게 일상생활동작 수행능력이 향상되었다(logit >0.3). 결론 : 한국형 전산화 인지재활 프로그램인 코트라스는 뇌졸중 환자의 시지각 기능을 향상시키는 효과가 있었고, 일상생활 동작 수행능력에 임상적으로 긍정적인 영향을 주었다. 시지각에 장애를 가지고 있는 뇌졸중 환자에게 코트라스(CoTras)가 시지각 기능 증진에 기여할 수 있는 기초자료로 제시할 수 있다.

• 한국산학기술학회논문지
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• 제16권10호
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• pp.7078-7088
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• 2015

본 연구의 목적은 노인 고혈압 환자의 건강행태, 수면 관련 요인이 인지기능에 미치는 영향을 파악하는 것이다. 연구대상은 지역사회에 거주하는 65세 이상 노인 중 고혈압을 진단 받은 140명이었다. 자료 수집은 2013년 2월 5일부터 5월 1일까지로 일대일면접 설문조사로 시행되었다. 연구도구는 Pittsburgh Sleep Quality Index(PSQI), Epworth Sleepiness Scale(ESS)와 한국어판 노인용 간이정신상태 검사 도구를 사용하여 측정하였다. 연구결과, 노인고혈압 환자의 인지기능은 수면의 질 저하와 유의한 음의 상관관계를 나타냈다(r=-.29, p<.001). 수면시간은 체질량지수(r=-.18, p=.032) 및 수면의 질 저하(r=-.59, p<.001)와 유의한 음의 상관관계가 있었고, 주간졸음과는 유의한 양의 상관관계가 있었다(r=.22, p=.008). 위계적 회귀분석 결과, 노인 고혈압 환자의 연령, 교육수준, 거주유형은 인지기능과 유의한 관련성이 있으며(F=8.56, p<.001, Adjusted $R^2=.14$), 인구사회학적 특성과 건강행태를 통제한 상태에서 수면의 질 저하(${\beta}=-.27$, p=.008)는 인지기능에 유의한 영향을 미치며, 최종 모형의 설명력은 17%였다(F=4.09, p<.001). 그러므로 노인 고혈압 환자의 인지기능 향상전략은 연령, 교육수준, 거주유형을 고려하고, 낮은 수면의 질을 향상 시킬 수 있는 치료적인 중재가 도움이 될 것으로 사료된다.