• 대한치매학회지
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• 제23권1호
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• pp.30-43
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• 2024

Background and Purpose: The SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention (SUPERBRAIN) proved the feasibility of multidomain intervention for elderly people. One-quarter of the Korean population over 65 years of age has mild cognitive impairment (MCI). Digital health interventions may be cost-effective and have fewer spatial constraints. We aim to examine the efficacy of a multidomain intervention through both face-to-face interactions and video communication platforms using a tablet personal computer (PC) application in MCI. Methods: Three hundred participants aged 60-85 years, with MCI and at least one modifiable dementia risk factor, will be recruited from 17 centers and randomly assigned in a 1:1 ratio to the multidomain intervention and the waiting-list control groups. Participants will receive the 24-week intervention through the tablet PC SUPERBRAIN application, which encompasses the following five elements: managing metabolic and vascular risk factors, cognitive training, physical exercise, nutritional guidance, and boosting motivation. Participants will attend the interventions at a facility every 1-2 weeks. They will also engage in one or two self-administered cognitive training sessions utilizing the tablet PC application at home each week. They will participate in twice or thrice weekly online exercise sessions at home via the ZOOM platform. The primary outcome will be the change in the total scale index score of the Repeatable Battery for the Assessment of Neuropsychological Status from baseline to study end. Conclusions: This study will inform the effectiveness of a comprehensive multidomain intervention utilizing digital technologies in MCI.

• 성인간호학회지
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• 제29권2호
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• pp.177-189
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• 2017

Purpose: A meta-analysis was conducted to identify the effect of cognitive improvement programs for the elderly with mild cognitive impairment (MCI) in Korea. Methods: Five databases, as well as relevant reference lists, of studies published from 2000 to 2016, were searched. Fourteen studies were identified. Quality assessments of included studies were conducted using the Scottish Intercollegiate Guidelines Network checklist. An R program was used to analyze effect sizes and to identify possible sources of heterogeneity among studies. The potential for publication bias was investigated using a funnel plot, Egger's regression test and sensitivity analysis. Results: The total effect size was large (Standardized Mean Difference [SMD]=1.44, 95% CI: 1.11~1.77), with cognition based intervention (SMD= 1.77, 95% CI: 1.26~2.29) and exercise intervention (SMD=1.13, 95% CI: 0.82~1.44). Statistically significant moderators were identified intervention type by meta-ANOVA analyses. Finally, no significant evidence of publication bias was found. Conclusion: There is clear evidence that cognitive improvement programs can greatly enhance cognition in elderly with MCI. Future research should examine the effects of non-pharmacological interventions targeting elderly populations with mild-to-severe cognitive impairment in order to develop and enhance the effectiveness of cognitive improvement programs in Korea.

• Physical Therapy Rehabilitation Science
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• 제10권4호
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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.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2016년도 추계학술대회
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• pp.749-751
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• 2016

가상현실의 등장으로 인해 과거의 이미지와 영상을 통한 커뮤니케이션 방법이 3차원 공간 속으로 확장되면서 보다 사실적이고 원활한 상호작용 환경을 제공하게 되었다. 가상현실은 현실과는 달리 인간의 완벽한 통제 하에 있다는 점을 통해 현실의 대체재로 활용이 가능하며 이 같은 장점으로 인해 의학과 헬스 케어 분야에서도 가상현실을 활용한 치매 예방 및 치료가 주목받고 있다. 본 논문에서는 치매 전조 현상인 경도인지장애에 초점을 맞추어 가상현실 기반의 경도인지장애 예방훈련 시스템을 설계하고자 한다.

• 한국융합학회논문지
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• 제9권5호
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• pp.121-127
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• 2018

본 연구는 55명의 노인 대상자를 무작위로 급속안구운동(saccadic eye movement, SEM)군과 원활추종눈운동(smooth pursuit eye movement, SPEM) 두 군으로 구분하여 4주 동안 안구운동을 실시한 후 사건관련 전위(event-related potentials)중 P300의 전위값과 잠복기 그리고 MMSE-DS를 사용하여 안구운동이 인지능력에 미치는 영향을 알아보고자 하였다. 그 결과 SEM과 SPEM 군의 P300 전위값은 유의하게 상승하였으며, P300의 잠복기는 유의하게 짧아졌다. MMSE-DS 결과 두 군 모두 유의한 상승을 나타냈으며, 군간 비교 시 SEM군은 지남력, SPEM군은 주의력에서 유의한 차이를 나타내었다. 결론적으로 SEM과 SPEM은 노인의 인지능력을 향상 및 유지를 시킬 수 있으며 치매예방과 경도 치매에 대한 치료 도구로 사용될 수 있을 것으로 생각된다.

• 한국보건간호학회지
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• 제19권2호
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• pp.371-381
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• 2005

Purpose: The purpose of the study was to develop the day care program for the demented elders and to determine the effects of multiple activity therapies on the physical, emotional, cognitive, social function and physiological indicators of dementia elders in day care center. Method: A total of 13 elders with mild dementia in the data care center were participated. Manual and guideline of data care program was developed. Data care program was composed of movement/exercise, foot massage, music therapy, horticultural therapy, and art therapy. Data care program was performed by trained intervener for 32 weeks. Instruments were physical functioning such as hand grip strength., vital capacity, chiar stand test, sit and reach test, one leg standing, Berg' Balance scale, 6m Walk Velocity, stair climb, ADL, GDS-K, MMSE-K, Integrative Social Functioning Scale, cortisol, Ig A and Ig G. These were measured at the baseline, 16-week, and 32-week post-intervention by the trained nurses. Data were analyzed as Wilcoxon signed rank test. Results: For Hand grip, balance, and vital capacity, there was a significant difference between baseline and 16-week post-intervention(p<.05). For one leg standing, 6m velocity, there was a significant difference between 16-week post-intervention and 32-week post-intervention(p<.05). For Stair climb, there was a significant difference between baseline and 32-week post-intervention(p<.05). For depression and social functioning, there was no significant difference among baseline, 16-week, and 32-week post-intervention. For cognitive functioning, there was a significant difference between baseline and 32-week post intervention(p<.05). There was a significant difference of cortisol, and Ig G between baseline and 32-week post-intervention(p<.05). Conclusion: It would appear that physical fitness, functional performance, ADL, depression, social and cognitive functioning, and physiological indicator of community dwelling elders with dementia can be improved through day care program using multiple stimuli.

• 대한치매학회지
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• 제22권2호
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• pp.69-77
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• 2023

Background and Purpose: The Montreal Cognitive Assessment (MoCA) has been known as a screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State Examination (MMSE). However, in previous domestic studies, no significant difference was found in the discriminability between MoCA and MMSE. Researchers have suggested that this might be because older Koreans are less educated than older Westerners. This study was conducted to examine the effect of education on the discriminability of MoCA compared to the MMSE. Methods: Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer's type. The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple regression analyses and receiver operating characteristic (ROC) curve analyses were performed. Results: In all participants, education significantly affected both K-MoCA and K-MMSE scores along with age. The effect of education was re-examined by subgroup analysis after dividing subjects according to the level of education. Effect of education on K-MoCA and K-MMSE was only shown in the group with <9 years of education. ROC curve analyses revealed that the discriminability of K-MoCA to differentiate between vascular MCI and normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups divided by education level, however, this higher discriminability of K-MoCA disappeared in the group with <9 years of education. Conclusions: These results indicate no difference in discriminating cognitive deficits between K-MoCA and K-MMSE in Korean elderly with <9 years of education.

• 대한치매학회지
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• 제21권2호
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• pp.71-78
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• 2022

Background and Purpose: The expression of the 18-kDA mitochondrial translocator protein (TSPO) in the brain is an attractive target to study neuroinflammation. However, the binding properties of TSPO ligands are reportedly dependent on genetic polymorphism of the TSPO gene (rs6971). The objective of this study is to investigate the rs6971 gene polymorphism in the Korean population. Methods: We performed genetic testing on 109 subjects including patients with mild cognitive impairment, Alzheimer's disease (AD) dementia, non-AD dementia, and cognitively unimpaired participants. Magnetic resonance imaging scans and detailed neuropsychological tests were also performed, and 29 participants underwent ¹⁸F-DPA714 PET scans. Exon 4 of the TSPO gene containing the polymorphism rs6971 (Ala or Thr at position 147) was polymerase chain reaction amplified and sequenced using the Sanger method. The identified rs6971 genotype codes (C/C, C/T, or T/T) of the TSPO protein generated high-, mixed-, or low-affinity binding phenotypes (HABs, MABs, and LABs), respectively. Results: We found that 96.3% of the study subjects were HAB (105 out of 109 subjects), and 3.7% of the subjects were MAB (4 out of 109 subjects). ¹⁸F-DPA-714 PET scans showed nonspecific binding to the thalamus and brainstem, and increased tracer uptake throughout the cortex in cognitively impaired patients. The participant with the MAB polymorphism had a higher DPA714 signal throughout the cortex. Conclusions: The majority of Koreans are HAB (aprox. 96%). Therefore, the polymorphism of the rs6971 gene would have a smaller impact on the availability of second-generation TSPO PET tracers.

• 한국산학기술학회논문지
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• 제19권5호
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• pp.312-322
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• 2018

본 연구는 뇌 활성화 중재프로그램을 경증치매노인에게 적용하여 경증치매노인의 인지기능, 행동심리적 증상, 우울 및 일상생활수행능력에 미치는 효과를 파악하는데 목적을 두고 수행 하였다. 본 연구의 연구 대상자는 실험군 20명과 대조군 20명으로 총 40명이었다. 본 연구의 자료 수집은 서울시 노원구에 소재한 치매지원센터에서 2016년 11월 1일부터 2017년 3월 31일까지 자료가 수집 되었다. 수집된 자료의 분석방법은 SPSS 23.0K을 이용하여 기술통계, Chi-square test, independent t-test, Two-way Repeated Measures ANOVA, ANCOVA로 분석 하였다. 본 연구에서 경증치매노인을 대상으로 뇌 활성화 중재프로그램을 8주간의 강의 및 프로그램을 시행한 결과 대상자 경증치매노인의 인지기능이 유의하게 향상되었고, 우울감이 유의하게 감소하였다. 본 연구 결과를 토대로 치매노인에게 적용한 뇌 활성화 중재프로그램으로 인지기능의 향상으로 일상생활에도 도움을 줄 수 있고, 치매노인의 우울을 완화시키는 것으로 나타나 차후에 지역사회 프로그램에 활용되도록 하는 기초자료로 지역사회에서 연계하는 프로그램으로 도움이 될 것으로 사료된다.

• 한국보건간호학회지
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• 제32권1호
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• pp.81-95
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• 2018

Purpose: This study was conducted to identify the effects of a group cognitive improvement program on cognitive function, depression and self-esteem in elderly individuals with mild cognitive impairment. Methods: This was an experimental study that employed a pre-post design of a non-equivalence control group. The subjects were 52 elderly people with mild cognitive impairment, 25 of whom were assigned to the experimental group and 27 to the control group. The program was conducted for a total of 12 sessions for 60 minutes each. Data were analyzed using the ${\chi}2-test$, Fisher's exact test, and Independent t-test with the SPSS 20.0 program. Results: After the intervention, the group who participated showed improvement in all areas of cognitive function based on MMSE-KC (F=26.37, p.<0.001), the Rey Complex Figure Test: copy (F=20.66, p.<0.001), Immediate memory of Seoul Verbal Learning Test-Elderly's version (F=29.68, p.<0.001), delayed memory (F=45.79 p.<0.001), memory recall (F=28.97, p.<0.001), Forward of Digit Span Test (F=9.25, p=.004), backward (F=8.33, p.=0.006), language comprehension (F=13.42, p.<0.001), and digit symbol coding (F=17.74, p.<0.001) relative to the control group. Moreover depression (F=24.09, p.<0.001) was decreased in program participants, whereas self-esteem (F=40.24, p.<0.001) was increased. Conclusion: The program could be a useful intervention because the results show that the group cognitive improvement program has a significant effect on cognitive function, depression and self-esteem in elderly with mild cognitive impairment.