• 제목/요약/키워드: Mild Cognitive Impairment (MCI)

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Prediction of Cognitive Progression in Individuals with Mild Cognitive Impairment Using Radiomics as an Improvement of the ATN System: A Five-Year Follow-Up Study

  • Rao Song;Xiaojia Wu;Huan Liu;Dajing Guo;Lin Tang;Wei Zhang;Junbang Feng;Chuanming Li
    • Korean Journal of Radiology
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    • 제23권1호
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    • pp.89-100
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    • 2022
  • Objective: To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). Materials and Methods: A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer's disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. Results: The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aβ42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer's continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer's disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. Conclusion: We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.

집단작업치료 프로그램이 경도인지장애 환자의 우울과 삶의 질에 미치는 영향 (The Effects of Group Occupational Therapy Program on Depression and Quality of Life in Patients with Mild Cognitive Impairment)

  • 박수정;김정기
    • 고령자・치매작업치료학회지
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    • 제12권2호
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    • pp.107-115
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    • 2018
  • 목적 본 연구의 목적은 집단작업치료 프로그램이 경도인지장애(MCI)를 가진 노인의 우울증과 삶의 질에 미치는 영향을 알아보고자 한다. 연구방법 경도인지장애 노인은 간이정신상태검사(Mini Mental State Examination-Dementia Screening, MMSEDS)를 기준으로 선정하였다. 대상자들의 집단작업치료 프로그램은 다양한 인지 영역으로 구성되어 6주 동안 12회 수행되었다. 노인우울증 척도 (SGDS-K)와 삶의 질 (QOL)을 사용하여 중재 전 후의 대상자의 우울증과 삶의 질을 평가하였다. 연구결과 경도인지장애(MCI) 노인은 집단 작업치료 중재 프로그램 후 노인우울증 척도 (SGDS-K)와 삶의 질(QOL)에서 통계학적으로 유의하게 향상되었다(p<0.05). 특히 삶의 질 평가 (QOL)중 일부 항목은 통계적으로 유의한 차이가 있었지만, SGDS-K와 QOL의 결과는 상관관계를 보이지 않았다(p>0.05). 결론 경도인지장애(MCI)를 가진 노인의 경우, 집단작업치료 프로그램을 6주 동안 시행했을 때 삶의 질(QOL)과 우울 증상은 중재 전 후비교에서 통계적으로 유의한 변화를 보였다.

복합재활중재 프로그램이 경도인지저하와 치매환자의 인지와 손기능에 미치는 연구 (The Effect of a Complex Rehabilitation Intervention Program on Cognitive and Hand Functions in Patients with Mild Cognitive Impairment and Dementia)

  • 정복희
    • 대한통합의학회지
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    • 제4권3호
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    • pp.49-59
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    • 2016
  • Purpose : The study was aimed to evaluate the improvement of cognitive and hand functions after the application of a complex rehabilitation intervention program on patients with mild cognitive impairment (MCI) and dementia who were living a regional community from. Methods : Subjects who were living in a regional sanatorium or who were outpatients of a community health center were enrolled from 2012. 2 to 2013.2 All subjects were enforced 8 cycles of a complex rehabilitation intervention program including RON dance, physical activity using therabands, reality awareness training, space retrieval training and handicraft activities. Results : There were significant improvement in LOTCA-G cognitive function and JTHFT hand function test after the application of a complex rehabilitation intervention program. Conclusion : The result shows a significant improvement in cognitive and hand functions after the application of a complex rehabilitation intervention program in patients with MCI and dementia. Therefore the authors suggest the vast studies of the cognitive function program development and hand function vitalization by the application of a complex rehabilitation intervention program.

경도인지장애 노인에게 적용된 인지기반 중재연구의 분석적 고찰 (Cognitive-based Intervention for the Older Adults with Mild Cognitive Impairment: A Literature Review)

  • 임세현
    • 한국융합학회논문지
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    • 제12권2호
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    • pp.327-336
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    • 2021
  • 국내 경도인지장애 노인의 약 10%는 매년 알츠하이머병이나 다른 치매로 이환된다. 이를 예방하기 위한 중재는 다양하게 수행되었으나, 이에 대한 근거의 통합은 시도되지 않았다. 이에 본 연구는 체계적인 문헌 고찰을 통해 경도인지장애 환자를 위한 인지 기반 중재와 그 효과를 알아보고자 수행되었다. 문헌의 검색은 2010년부터 2020년 9월까지 학술연구정보서비스(Riss)와 KoreaMed를 활용하였다. 문헌의 선택 및 배제 과정을 거쳐 최종 12편이 선정되었으며, 비동등성 대조군 전후 유사 실험연구가 7편으로 가장 많았다. 본 연구의 분석 결과, 경도인지장애 노인을 위한 인지기반 중재는 인지기능과 우울, 신체 건강 상태, 자아존중감, 운동 시·지각 검사, 생활 만족도, 자기효능감, 뇌파, 삶의 질, 의사소통과 상호작용기술평가 등에 긍정적인 영향을 주는 것으로 나타났다. 본 연구 결과를 토대로 경도인지장애 노인을 위한 중재 프로그램의 효과를 검증하기 위한 반복 연구를 제언한다.

주관적 기억장애 및 경도인지장애 노인의 의미연상과제 수행 특성 (The Characteristics of semantic association task performance in elderly with subjective memory impairment and mild cognitive impairment)

  • 강서정;박성현;김정완
    • 디지털융복합연구
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    • 제17권2호
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    • pp.283-292
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    • 2019
  • 초기의 인지 감퇴를 판단하는 요소로 의미지식 및 의미 연관관계의 범주별 손상 유무가 주목을 받고 있다. 본 연구에서는 정상 및 주관적 기억장애, 경도인지장애 노인을 대상으로 의미연상과제를 사용하여 인지 감퇴의 정도에 따라 관찰되는 의미 하위범주별 수행과 오류유형의 차이를 살펴보고자 하였다. 연구 결과, 의미연상과제 범주별 정반응 점수와 반응시간에서 세 군 간 유의한 차이를 보였으며, 하위범주 중, '기능'에서 가장 높은 수행력을, '상위'와 '부분/전체'에서 가장 낮은 수행력을 보였다. 또한, 오류유형별 산출 횟수는 정상에서 경도인지장애 노인으로 갈수록 유의하게 높아졌으며, 무반응은 주관적 기억장애 노인부터 유의하게 증가하였다. 결론적으로, 인지 감퇴가 진행될수록 의미연결망에서 범주별 손상의 정도와 과정이 다르므로, 기억장애 노인의 인지적 감퇴를 확인하고 추적 관찰하기 위한 지표로 의미연상과제 수행력을 활용할 수 있을 것이다.

경도인지장애의 침 치료에 대한 무작위배정 대조 임상시험(RCT) 연구 논문에 대한 질 평가 : STRICTA와 CONSORT 지침을 바탕으로 (Quality Assessment of Studies on Randomized Controlled Trials (RCTs) of Acupuncture Treatment for Mild Cognitive Impairment: Based on the STRICTA and CONSORT Guidelines)

  • 신여옥;허우영;이인
    • 대한한방내과학회지
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    • 제40권6호
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    • pp.1101-1111
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    • 2019
  • Objective: The purpose of this study was to investigate quality of reporting acupuncture intervention for mild cognitive impairment (MCI) based on the STRICTA and CONSORT guidelines Methods: We searched for randomized controlled trial studies of acupuncture treatment for MCI in the MEDLINE (PubMed) database. Once the online search was completed, studies were selected manually by the inclusion criteria, and the selected studies were evaluated by STRICTA and CONSORT guidelines. Results: Five studies were included. The most frequently selected points for acupuncture treatment of MCI were on the head, such as GV20, EX-HN1, GV24, and GB20. By STRICTA guidelines, all items from STRICTA were reported except three items on the checklist. By CONSORT guidelines, apart from six items which were not available, quality assessment was performed with 31 items. Eighteen items were reported by 80% of the studies. Four items were reported by 40% of the studies and another four items were reported by 20% of the studies. One item was not reported in all studies. Conclusion: Most items were reported by STRICTA guidelines, whereas many items were insufficiently reported based on CONSORT guidelines. This needs to be considered in future RCTs of acupuncture treatment for MCI.

Association between diets and mild cognitive impairment in adults aged 50 years or older

  • Kim, Kyoung Yun;Yun, Jung-Mi
    • Nutrition Research and Practice
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    • 제12권5호
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    • pp.415-425
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    • 2018
  • BACKGROUND/OBJECTIVE: As aging progresses, the number of patients with cognitive impairment also increases. Cognitive function is not generally correlated with diet, and there is debate over that association. Thus, the present study aimed to investigate the association between dietary intake and cognitive function among adults aged 50 years or older. SUBJECTS/METHODS: Between July 2017 and March 2018, 324 adults aged over 50 years from Gwangju Sun-Han hospital participated in a dietary survey. The frequency of food intake and related information were collected using a semi-quantitative food frequency questionnaire (SQ-FFQ) and determining the mini-mental state examination (MMSE) level for 276 participants. The association between dietary intake and cognitive function was assessed by performing logistic regression analysis. RESULTS: Depending on the MMSE score, the participants' age, education level, inhabitation status, medications, alcohol consumption, sleep duration, physical activity, and short geriatric depression scale score were significantly different (P < 0.05). Moreover, those participant characteristics were associated with either decreased or increased odds ratios (OR) for the risk of mild cognitive impairment (MCI). Based on analysis of the participants' intake of 112 detailed food items, which were categorized into 20 food types, intakes of cooked white rice (< 2 times/day compared with ${\geq}3$ times/day) (P < 0.05), properly cooked rice with other grains and legumes (P < 0.001), fruits (P < 0.05), milk (low fat and normal) (P = 0.044), liquid-type yogurt (P = 0.019), and curd-type yogurt (P = 0.015) were found to significantly decrease the OR for the risk of MCI. CONCLUSIONS: Associations were significant between the risk of MCI and the intake of certain food types. Specifically, a moderate intake of cooked white rice and an adequate intake of whole grains, fruits, milk, and dairy products were associated with reduced risks of MCI among adults aged over 50 years.

지역사회 거주 경도인지장애 노인의 유병율과 정상 노인과의 비교연구 (Prevalence and Characteristics of Mild Cognitive Impairment in the Community-dwelling Elderly Compared to Elderly with Normal Cognitive Function)

  • 신경림;강윤희;정덕유;김미영;김정수;김미정;김민정
    • 성인간호학회지
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    • 제23권1호
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    • pp.40-49
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    • 2011
  • Purpose: This study aimed to identify the prevalence of mild cognitive impairment (MCI) among a group of community-dwelling elderly and to determine if there were differences in general characteristics, activities of daily living (ADL), perceived health status (PHS) between the MCI group and group of elderly with normal cognitive function. Methods: This study utilized a descriptive survey design. Six hundred and five subjects over the age 65 were recruited from an S public health center, Seoul. Data were gathered through a variety of instruments: MoCA-K, K-MMSE, K-MBI, S-IADL, and PHS scale. Data were analyzed by SPSS/WIN 18.0 using descriptive statistics, Chi-Square test and t-test. Results: The prevalence of MCI among the subjects was 46.0%. Differences in IADL, PHS, age, education, sex, and residing with a spouse were statistically significant between groups. The MCI group had lower IADL, lower PHS, were older, and had lower educational levels than the group with normal cognitive function. Further, the MCI group was less likely to live with a spouse. Conclusion: It is suggested that MCI group should be targeted in developing and implementing nursing strategies to prevent dementia and improve the elderly cognitive function.

오차배제훈련을 병행한 시간차 회상훈련이 경도인지장애 환자의 기억력에 미치는 효과와 수단적 일상생활(IADL) 및 우울에 미치는 영향: 단일대상연구 (The Effects of Spaced Retrieval Training with Errorless Learning on Memory, IADL, Depression in Mild Cognitive Impairment: Single-Subject Design)

  • 김연주;박혜연
    • 재활치료과학
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    • 제4권2호
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    • pp.73-83
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    • 2015
  • 목적 : 본 연구는 오차배제훈련을 병행한 시간차회상훈련이 경도인지장애(Mild Cognitive Impairment; MCI) 환자의 기억력에 미치는 효과와 수단적 일상생활(Instrumental Activities of Daily Living; IADL) 및 우울에 미치는 영향을 알아보고자 하였다. 연구방법 : 주간보호시설에 등록된 78세 MCI 노인을 대상으로 단일 대상 실험 연구 중 ABA 설계를 사용하여 실험을 진행하였다. 연구를 진행한 총 16회기 중 기초선 A는 총 3회기, 중재기간 B는 총 10회기, 기초선 A'는 총 3회기였다. 기억력을 측정하기 위한 회기별 평가로 Rey-Kim 언어 기억 검사(K-Auditory Verbal Learning Test; K-AVLT)를 사용하였고, 인지기능, IADL 수행 능력, 우울을 측정하기 위하여 각각 한국판 몬트리올 인지평가(Korean version of Montreal Cognitive Assessment; MoCA-K), 필라델피아 노인 센터 IADL 도구(Philadelphia Geriatric Center Instrumental Activities Daily Living; PGC IADL), 한국판 노인우울척도(Geriatric Depression Scale Korean Version; GDS-K)를 사용하였다. 결과 : 대상자는 기초선 A기간에 비하여 중재를 제공한 B기간에서의 즉시회상 및 지연회상이 현저히 증가하였다. 또한, 즉시회상과 지연회상 모두 B 기간에서 증가하던 측정값의 경향이 중재를 제거한 후인 기초선 A'구간에서 감소하는 경향을 보였다. MoCA-K 점수는 향상을 보였으며, PGC IADL 점수는 중재 전과 후가 같았고 GDS-K의 점수는 감소하였다. 결론 : 본 연구의 결과를 통하여 MCI 환자를 대상으로 실시한 오차배제훈련을 병행한 시간차 회상훈련의 근거를 확고히 하였다. 나아가 MCI 환자들이 기억력과 함께 어려움을 겪는 요인을 향상시키기 위한 중재 및 기억력과 다른 기능적 요소들에 대한 상관관계에 대하여 추가적인 연구가 필요할 것이다.

Emerging evidence that ginseng components improve cognition in subjective memory impairment, mild cognitive impairment, and early Alzheimer's disease dementia

  • Rami Lee;Ji-Hun Kim;Won-Woo Kim;Sung-Hee Hwang;Sun-Hye Choi;Jong-Hoon Kim;Ik-Hyun Cho;Manho Kim;Seung-Yeol Nah
    • 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).