• 대한치매학회지
• /
• 제23권1호
• /
• pp.30-43
• /
• 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.

• 한국전자통신학회논문지
• /
• 제17권6호
• /
• pp.1207-1212
• /
• 2022

4차 산업혁명 시대의 차세대 미디어 기술인 실감미디어는 사용자 경험을 최적화 하는 환경을 통해 체험하는 기술로 이슈화 되고 있고, 보건·헬스케어 융·복합분야로 빠르게 발전하고 있다. 노년층의 인구 증가로 만성질환의 증가, 인지훈련 및 재활분야의 인프라와 전문인력의 부족으로 이를 해결하기 위해 실감미디어 기술과 서비스를 채택하고 있다. 이에 본 연구는 인지 재활이 필요한 경도인지장애 MCI(: Mild cognitive impairment) 대상자를 대상으로 인지능력과 일상생활 활동능력을 향상시키는 목적으로 인지 훈련 시스템을 설계하고 구현하였다. 향후 AI와 BigData 기반의 지능형 인지재활 통합 플랫폼으로 쌍방향 컴뮤니케이션과 즉각적인 피드백이 존재하는 통합 서비스 플랫폼을 연구과제로 남긴다.

• 정신신체의학
• /
• 제24권1호
• /
• pp.94-101
• /
• 2016

연구목적 본빈혈은 노인 환자들에서 흔한 내과적 문제이다. 최근 연구는 빈혈이 인지기능 저하 및 알츠하이머병 치매와 연관성이 있다고 보고되고 있다. 본 연구는 한국 노인들에서 헤모글로빈 농도와 알츠하이머병 치매 및 경도 인지기능 장애와의 연관성에 대해 연구하기 위해 실시되었다. 방 법 116명의 대상자들이 본 연구에 참여하였다(평균 연령 : 74.67세, 여성 : 60.3%). 한국판 간이정신상태검사(MMSE-K), 임상치매평가척도(CDR), 전반적 퇴화척도(GDS)를 사용하여 대상자들을 평가하였고, 혈액학적 검사를 실시하였다. 결 과 알츠하이머병 치매 환자들이 경도인지장애군과 정상군에 비해서 유의미하게 낮은 헤모글로빈 농도와 적혈구 용적율을 가진다는 것이 관찰되었다. 헤모글로빈 농도는 MMSE-K와 양의 상관관계를 나타내었으며, overall CDR 및 GDS와는 음의 상관관계를 보였다. 결 론 한국 노인들에서 낮은 헤모글로빈 농도는 인지기능손상과 연관이 있는 것으로 나타났다. 본 연구 결과 알츠하이머병 치매는 빈혈과 연관이 있었으며, 이를 통해 낮은 헤모글로빈 농도가 알츠하이머병의 유용한 임상적 표지자로서 의미를 가지고 있다고 생각해 볼 수 있겠다. 치매에 대한 위험 요소는 더 광범위한 환자 군에서 전향적 종단 연구에 의해 확인하는 것이 필요하겠다.

• 대한치매학회지
• /
• 제21권1호
• /
• 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.

• 동의신경정신과학회지
• /
• 제32권2호
• /
• pp.81-93
• /
• 2021

Objectives: Mild cognitive impairment (MCI) is condition of cognitive decline shown in transition from normal aging to dementia. Hominis placenta pharmacopuncture (HPP) is a treatment that combines effects of medication and acupuncture by injecting Hominis placenta into acupoints. The objective of this study was to evaluate the efficacy and safety of HPP for MCI. Methods: This was a randomized, double-blind, placebo-controlled, two-center clinical trial. Eligible patients were randomly allocated to either the HPP group or the placebo group. HPP or saline as placebo was administered to participants for eight weeks. Changes in symptoms were observed. The primary outcome was difference in mean change of Korean Version of the Montreal Cognitive Assessment (MoCA-K) score between the HPP group and the placebo group. Cognitive function, overall status of mood and sleep, and quality of life (QoL) were also assessed. Safety assessment and economic analysis were then conducted. Results: Thirty participants were enrolled. One participant in the placebo group dropped out. The score of MoCA-K increased after treatment. Its mean change was smaller in the HPP group than in the control group. HPP ameliorated Global Deterioration Scale and Korean Dementia Rating Scale subtests for attention, organization, and memory compared to the placebo. However, none of them was significantly different between the two groups. Mood, sleep, and QoL all improved more in the HPP group than in the placebo group, although differences between the two groups were not statistically significant. There was no adverse event probably related to the drug. HPP treatment needed KRW 345,000 more than the placebo group in improving Geriatric Quality of Life scale-Dementia score by one point for one year. Conclusions: Although HPP treatment did not significantly improve cognition, it changed behavioral and psychological symptoms in MCI.

• 한국콘텐츠학회논문지
• /
• 제19권7호
• /
• pp.628-637
• /
• 2019

본 연구는 경도인지장애가 있는 노인을 대상으로 ICF 영역으로 분류하여 지역사회기반 중재의 효과에 대해 체계적 고찰 및 메타분석을 하고자 하였다. 2009년 1월부터 2019년 1월까지 국내 외에 게재된 연구로 PubMed MEDLINE, Cochrane CENTRAL, Google Scholar, 한국학술지인용색인, RISS, 국회도서관 데이터베이스에서 검색하였다. 선정논문의 실험군, 대조군의 대상자 수, 평균, 표준 편차를 사용하여 통계적 이질성, 효과 크기, 출판 편의를 산출하였다. 그 결과 총 5편 연구가 선정되었고, 대상자는 실험군 144명, 대조군 152명 총 296명이었다. 지역 사회 재활 프로그램의 전체 효과 크기는 8.83이였고, ICF 영역별 효과 크기는 신체기능 및 구조에서는 4.77, 활동과 참여에서는 6.17로 큰 효과 크기를 보였다. 본 연구의 결과를 통해 경도 인지장애가 있는 노인의 지역사회기반 재활의 신체기능 및 구조, 활동과 참여에 효과적임을 알 수 있었다.

• 디지털융복합연구
• /
• 제20권3호
• /
• pp.517-527
• /
• 2022

본 연구의 목적은 치매, 경도인지장애, 허혈성 뇌졸중 환자의 인지기능, 우울과 일상생활수행능력의 변화를 비교하고 도구적 일상생활수행능력의 변화를 설명하는 요인을 확인하기 위함이다. 총 86명(치매=30명, 경도인지장애=32명, 허혈성 뇌졸중=24명)으로부터 진단 시점과 1년 뒤에 인지기능, 우울, 기본적 및 도구적 일상생활수행능력 자료를 수집하여 분석하였다. 반복측정분산분석과 다중회귀분석을 이용하였다. 집행기능(p=.037)과 도구적 일상생활수행능력(p=.023)에서 측정 시점에 따른 집단 간 교호작용이 유의한 것으로 확인되었다. 경도인지장애 집단은 진단 후 1년 동안 집행기능과 도구적 일상생활수행능력의 변화가 거의 없었으나, 시간이 지남에 따라 치매 집단에서는 감소하는 양상이 나타났고 허혈성 뇌졸중 집단에서는 향상되는 양상을 나타냈다. 또한, 집행기능이 저하될수록(p=.030), 기본적 일상생활수행능력이 저하될수록(p<.001) 도구적 일상생활수행능력도 저하되는 것으로 확인되었으며 설명력은 26.9%였다. 이러한 결과는 인지변화를 주요 증상으로 가지는 치매, 경도인지장애, 허혈성 뇌졸중 환자에서 진단 후 1년까지 질병의 초기 단계에 각기 다른 집행기능 변화 양상이 나타났으며, 이로 인해 도구적 일상생활수행능력 변화 양상이 다른 것으로 보인다. 보건의료전문가는 진단 직후부터 집행기능과 도구적 일상생활수행능력 문제를 정기적으로 평가하고 이와 관련된 기능 상태를 유지 및 증진하기 위한 중재를 제공해야 할 것이다.

• 생물정신의학
• /
• 제27권2호
• /
• pp.94-100
• /
• 2020

Objectives Amyloid β positron emission tomography (Aβ PET) is widely used as a diagnostic tool in patients who have symptoms of cognitive impairment, however, this diagnostic examination is too expensive. Thus, predicting the positivity of Aβ PET before patients undergo the examination is essential. We aimed to analyze clinical predictors of patients who underwent Aβ PET retrospectively, and to develop a predicting model of Aβ PET positivity. Methods 468 patients who underwent Aβ PET with cognitive impairment were recruited and their clinical indicators were analyzed retrospectively. We specified the primary outcome as Aβ PET positivity, and included variables such as age, sex, body mass index, diastolic blood pressure, systolic blood pressure, education, dementia family history, Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Box (CDR-SB), hypertension (HTN), diabetes mellitus (DM) and presence of apolipoprotein E (ApoE) E4 as potential predictors. We developed three final models of amyloid positivity prediction for total subjects, mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using a multivariate stepwise logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) value was calculated for the ROC curve. Results Aβ PET negative patients were 49.6% (n = 232), and Aβ PET positive patients were 50.4% (n = 236). In the final model of all subjects, older age, female sex, presence of ApoE E4 and lower MMSE are associated with Aβ PET positivity. The AUC value was 0.296. In the final model of MCI subjects (n = 244), older age and presence of ApoE E4 are associated with Aβ PET positivity. The AUC value was 0.725. In the final model of AD subjects (n = 173), lower MMSE scores, the presence of ApoE E4 and history of HTN are associated with Aβ PET positivity. The AUC value was 0.681. Conclusions The cerebral amyloid positivity model, which was based on commonly available clinical indicators, can be useful for prediction of amyloid PET positivity in MCI or AD patients.

• 한국보건간호학회지
• /
• 제29권2호
• /
• pp.219-230
• /
• 2015

Purpose: This research study not only examine the relationship between cognitive function, IADL, depression and quality of life, but also clarifies factors impacting quality of life for the elderly. The purpose of this study is to administer health promotion programs and to improve quality of life for the elderly. Methods: Data were collected from May 20, to June 10, 2014. The participants were 157 elderly persons with mild cognitive injury (MCI), who had under 23 points on MoCa-K from three different senior welfare centers in Daejeon. The questionnaires were conducted by four university students after receiving instruction from the researcher and consisted of general characteristics, cognitive function, depression and quality of life. SPSS WIN 19.0 program was used for data analysis. Results: Cognitive function showed positive correlation with quality of life (r=175, p=.028). IADL did not show correlation with quality of life (r=-.005, p=.947). However cognitive function(r=-.344, p<.001) and depression (r=-.623, p<.001) showed negative correlation with quality of life. In addition, the factors impacting quality of life were cognitive function (${\beta}=.14$, p=.29) and depression (${\beta}=-.61$, p<.001) which accounted for 39% of quality of life. Conclusion: These findings showed that the participants had depression and their cognitive function was low. As a result, the more participants' cognitive function decreased, the more their quality of life decreased. In addition, the more their depression decreased, the more their quality of life improved.

• 한국멀티미디어학회논문지
• /
• 제15권12호
• /
• pp.1449-1455
• /
• 2012

This paper has developed a system for early diagnosis of senile dementia and mild cognitive impairment (MCI) by developing software to measure the volume of hippocampus. This software consists of two parts; segmentation and analysis. The segmentation part uses ROI and region growing to segment hippocampus region. On the other hand, the analysis part creates a volume rendering of hippocampus. This software is expected contribute in these research fields for dementia diagnosis and its medication planning.