• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.136-144
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• 2017

Objectives : Cognitive complaints are reported frequently after breast cancer treatments. The causes of cognitive decline are multifactorial, a result of the effect of cancer itself, chemotherapy, and psychological factors such as depression and anxiety. However, cognitive decline does not always correlate with neuropsychological test performance. The purpose of this study was to examine the relationship of subjective cognitive decline with objective measurement and to explore associated factors of cognitive function in breast cancer survivors. Methods : We included 29 breast cancer survivors who complain cognitive decline at least 6 months after treatment and 20 age-matched healthy controls. Neuropsychological tests were performed in all participants. Multivariable regression analysis evaluated associations between neuropsychological test scores and psychological distress including depression and anxiety, also considering age, education, and comorbidity. Results : There were no statistically significant differences in neuropsychological test performances. However, the breast cancer survivors showed a significantly higher depression(p=0.002) and anxiety(p<0.001) than the healthy controls did. Among the cancer survivors, poorer executive function was strongly associated with higher depression(${\beta}=-0.336$, p=0.001) and anxiety(${\beta}=-0.273$, p=0.009), after controlling for age, education, and comorbidity. In addition, poorer attention was also significantly related with depression(${\beta}=-0.375$, p=0.023) and anxiety (${\beta}=-0.404$, p=0.013). Conclusions : The results of this study showed the discrepancies between subjective complaints and objective measures of cognitive function in breast cancer survivors. It suggests that subjective cognitive decline could be indicators of psychological distress such as depression and anxiety.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.1-11
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• 2012

Purpose: This study reviewed articles related to breast cancer, cognitive function and chemotherapy available in 4 databases. Methods: The researcher reviewed 32 pieces of literature that were published between January 2001 and November 2011. Results: Within the last decade, several studies have investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have reported inconsistent results regarding whether chemotherapy affects cognitive function. Approximately half of the studies reported subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and others did not. Conclusion: Breast cancer patients receiving adjuvant chemotherapy showed the most deterioration and the most persistent decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Especially, that chemotherapy may impair memory, executive function, attention and visuospatial function in women with breast cancer.

• Journal of Educational Research in Mathematics
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• v.15 no.3
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• pp.251-272
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• 2005

Given that cognitive demands of mathematical tasks can be changed during instruction, this study attempts to provide a detailed description to explore how tasks are set up and implemented in the classroom and what are the classroom-based factors. As an exploratory and qualitative case study, 4 of six-grade classrooms where high-level tasks on ratio and proportion were used were videotaped and analyzed with regard to the patterns emerged during the task setup and implementation. With regard to 16 tasks, four kinds of Patterns emerged: (a) maintenance of high-level cognitive demands (7 tasks), (b) decline into the procedure without connection to the meaning (1 task), (c) decline into unsystematic exploration (2 tasks), and (d) decline into not-sufficient exploration (6 tasks), which means that the only partial meaning of a given task is addressed. The 4th pattern is particularly significant, mainly because previous studies have not identified. Contributing factors to this pattern include private-learning without reasonable explanation, well-performed model presented at the beginning of a lesson, and mathematical concepts which are not clear in the textbook. On the one hand, factors associated with the maintenance of high-level cognitive demands include Improvising a task based on students' for knowledge, scaffolding of students' thinking, encouraging students to justify and explain their reasoning, using group-activity appropriately, and rethinking the solution processes. On the other hand, factors associated with the decline of high-level cognitive demands include too much or too little time, inappropriateness of a task for given students, little interest in high-level thinking process, and emphasis on the correct answer in place of its meaning. These factors may urge teachers to be sensitive of what should be focused during their teaching practices to keep the high-level cognitive demands. To emphasize, cognitive demands are fixed neither by the task nor by the teacher. So, we need to study them in the process of teaching and learning.

• Journal of Biomedical Engineering Research
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• v.43 no.4
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• pp.185-192
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• 2022

Early detection of mild cognitive impairment can help prevent the progression of dementia. The purpose of this study was to design and validate a machine learning model that automatically differential diagnosed patients with mild cognitive impairment and identified cognitive decline characteristics compared to a control group with normal cognition using resting-state quantitative electroencephalogram (qEEG) with eyes closed. In the first step, a rectified signal was obtained through a preprocessing process that receives a quantitative EEG signal as an input and removes noise through a filter and independent component analysis (ICA). Frequency analysis and non-linear features were extracted from the rectified signal, and the 3067 extracted features were used as input of a linear support vector machine (SVM), a representative algorithm among machine learning algorithms, and classified into mild cognitive impairment patients and normal cognitive adults. As a result of classification analysis of 58 normal cognitive group and 80 patients in mild cognitive impairment, the accuracy of SVM was 86.2%. In patients with mild cognitive impairment, alpha band power was decreased in the frontal lobe, and high beta band power was increased in the frontal lobe compared to the normal cognitive group. Also, the gamma band power of the occipital-parietal lobe was decreased in mild cognitive impairment. These results represented that quantitative EEG can be used as a meaningful biomarker to discriminate cognitive decline.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.375-385
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• 2019

Purpose: This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model. Methods: The Participants consisted of 250 patients who were ${\geq}19$ years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. Results: The modified model was a good fit for the data. The model fit indices were ${\chi}^2=423.18$ (p<.001), ${\chi}^2/df=3.38$, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (${\beta}=.38$, p=.002), depression and anxiety (${\beta}=.25$, p=.002), and symptom experiences (${\beta}=.19$, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (${\beta}=-.51$, p=.001), symptom experiences (${\beta}=-.27$, p=.001), menopausal symptoms (${\beta}=-.22$, p=.008), and chemotherapy-related cognitive impairment (${\beta}=-.15$, p=.024) had direct effects on the quality of life and these variables explained 91.3%. Conclusion: These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.

• Korean Journal of Social Welfare Studies
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• v.44 no.2
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• pp.327-358
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• 2013

This study aimed to analyze the trajectories of cognitive function and functional disability, and to identify the impacts of socio-demographic factors on the two variables. Based on the assumption that there are differences according to the progress of cognitive impairment, it focused on examining the differences in trajectories of cognitive function and functional disability between two groups: dementia conversion group and dementia non-conversion group among cognitively normal older adults. This study was conducted based on the data from a 3-wave panel study of a sample of 966 Yeoncheon elderly cohort aged 65 and over between 1997 and 2003. Latent growth curve model and multi-group structural equation modeling were used to examine the hypothesis. Results revealed that dementia conversion group exhibited faster rate of cognitive decline as well as lower initial cognitive level. Difference between two groups was not significant in the initial level of functional disability, yet dementia conversion group showed greater degree of deterioration in the functional disability over time than dementia non-conversion group did. In terms of the influence of socio-demographic factors on cognitive function and functional disability, the cognitive decline was more drastic in the female group, whereas functional decline was more apparent for the male group. The level of education in early life had a strong impact on the cognitive function in later life. Based on these findings, practical implication for high risk groups in cognitive function and functional disability were discussed.

• Journal of Oriental Neuropsychiatry
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• v.30 no.3
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• pp.185-198
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• 2019

Objectives: The purpose of this study was to identify the effectiveness of Korean medicine treatment in mild cognitive impairment (MCI) among a group of community dwelling elderly. Methods: Two-hundred and twenty-nine elderly living in a community and diagnosed with MCI were recruited. Participants were evaluated with various instruments such as the Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Korean version of Montreal Cognitive Assessment (MoCA-K). Korean medicine treatment consisted of herbal medicine, acupuncture, and pharmacoacupuncture. The change in cognitive ability was assessed by using the MMSE-DS and the MoCA-K. Data were analyzed by SPSS/WIN 22.0 using the paired t-test, and the ANOVA. Results: The MMSE-DS and the MoCA-K score generally increased after six months of Korean medicine treatment and the differences in both instruments were statistically significant. Additionally, some consecutive participants maintained long-term cognitive improvement. When analyzed specifically by herbal medicine group based on syndrome differentiation and pharmacoacupuncture group, most showed improvement in the MMSE-DS and the MoCA-K but not all data were statistically significant. The satisfaction score was mostly high and most participants were willing to re-participate in the program. Conclusions: Korean medicine treatment may contribute to the improvement and prevention of cognitive decline in the elderly. However, further systematic research based on large scale sample data and standardized protocols is needed to uplift the welfare and mental health of the elderly.

• Journal of Life Science
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• v.29 no.6
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• pp.747-753
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• 2019

Cognitive decline is characterized by reduced long-/short-term memory and attention span, and increased depression and anxiety. Such decline is associated with various degenerative brain disorders, especially Alzheimer's disease (AD) and Parkinson's disease (PD). The increases in elderly populations suffering from cognitive decline create social problems and impose economic burdens, and also pose safety threats; all of these problems have been extensively researched over the past several decades. Possible causes of cognitive decline include metabolic and hormone imbalance, infection, medication abuse, and neuronal changes associated with aging. However, no treatment for cognitive decline is available. In neurodegenerative diseases, changes in the gut microbiota and gut metabolites can alter molecular expression and neurobehavioral symptoms. Changes in the gut microbiota affect memory loss in AD via the downregulation of NMDA receptor expression and increased glutamate levels. Furthermore, the use of probiotics resulted in neurological improvement in an AD model. PD and gut microbiota dysbiosis are linked directly. This interrelationship affected the development of constipation, a secondary symptom in PD. In a PD model, the administration of probiotics prevented neuron death by increasing butyrate levels. Dysfunction of the blood-brain barrier (BBB) has been identified in AD and PD. Increased BBB permeability is also associated with gut microbiota dysbiosis, which led to the destruction of microtubules via systemic inflammation. Notably, metabolites of the gut microbiota may trigger either the development or attenuation of neurodegenerative disease. Here, we discuss the correlation between cognitive decline and the gut microbiota.

• Korean Journal of Food Science and Technology
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• v.53 no.3
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• pp.278-289
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• 2021

The rapid aging of society has led to a surge in cognitive dysfunction in the elderly. As there is limited evidence for the development of dementia in medicine, a shift in focus on prevention strategies using bioactive compounds in food is required. This systematic review evaluated the effects of various bioactive compounds on age-associated cognitive decline. The literature was searched for terms related to bioactive compounds in cognitive decline and article selection was limited to clinical randomized controlled trials for a single bioactive compound. We identified 21 studies that evaluated the strength of the evidence. ω-3 fatty acids and vitamin B presented a strong evidence level, whereas vitamin D and E, anserine/carnosine, and chromium were defined as having moderate levels of evidence. ω-3 fatty acids relieved cognitive decline and reduced amyloid β-related protein accumulation. Vitamin B decreased homocysteine levels, which is accompanied by alleviation of cognitive function. In conclusion, ω-3 and vitamin B have the potential to improve age-associated cognitive decline.

• Journal of Ginseng Research
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• v.48 no.3
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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).