• 대한의사협회지
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• 제61권12호
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• pp.758-764
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• 2018

Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

• International Journal of Advanced Culture Technology
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• 제9권2호
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• pp.18-31
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• 2021

The purpose of the present study was to present evidence for driving interventions for the elderly by conducting programs that can improve visual perception and cognitive function in a driving simulator for elderly drivers and analyse their effects. Three elderly subjects who were 65 years or older, did not have physical and cognitive impairments, and were able to drive themselves participated in the present study. A total of 12 intervention sessions, of which subjects participated in 10 sessions of nine different visual perception and cognitive function programs available in a driving simulator, were conducted and pre- and post-program assessments were conducted (two assessments in total). The assessments included the evaluation of visual perception, frontal lobe function, concentration, safe driving behaviour, and self-efficacy. The results showed positive effects of the driving simulator program on the visual perception, frontal lobe function, concentration, safe driving behaviour, and self-efficacy of all subjects. Changes in the simulator results showed remarkable improvement in the response evaluation, judgment evaluation, and predictive power evaluation, but showed difficulties in interference tasks and depth perception in common. The results showed positive effects of driving simulator training on the driving ability of the elderly, and consistent provision of such training is expected to improve the quality of life of the elderly by securing the safety of driving and actively supporting social participation.

• Clinical and Experimental Pediatrics
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• 제63권6호
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• pp.219-225
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• 2020

Background: There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance. Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants. Methods: Children aged 7-10 years who were born at 32⁺⁰ to 36⁺⁶ weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires. Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes. Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.

• Journal of Ginseng Research
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• 제47권4호
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• pp.561-571
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• 2023

Background: Escalating evidence shows that ginseng possesses an antiaging potential with cognitive enhancing activity. As mountain cultivated ginseng (MCG) is cultivated without agricultural chemicals, MCG has emerged as a popular herb medicine. However, little is known about the MCG-mediated pharmacological mechanism on brain aging. Methods: As we demonstrated that glutathione peroxidase (GPx) is important for enhancing memory function in the animal model of aging, we investigated the role of MCG as a GPx inducer using GPx-1 (a major type of GPx) knockout (KO) mice. We assessed whether MCG modulates redox and cholinergic parameters, and memory function in aged GPx-1 knockout KOmice. Results: Redox burden of aged GPx-1 KO mice was more evident than that of aged wild-type (WT) mice. Alteration of Nrf2 DNA binding activity appeared to be more evident than that of NFκB DNA binding activity in aged GPx-1 KO mice. Alteration in choline acetyltransferase (ChAT) activity was more evident than that in acetylcholine esterase activity. MCG significantly attenuated reductions in Nrf2 system and ChAT level. MCG significantly enhanced the co-localization of Nrf2-immunoreactivity and ChAT-immunoreactivity in the same cell population. Nrf2 inhibitor brusatol significantly counteracted MCG-mediated up-regulation in ChAT level and ChAT inhibition (by k252a) significantly reduced ERK phosphorylation by MCG, suggesting that MCG might require signal cascade of Nrf2/ChAT/ERK to enhance cognition. Conclusion: GPx-1 depletion might be a prerequisite for cognitive impairment in aged animals. MCG-mediated cognition enhancement might be associated with the activations of Nrf2, ChAT, and ERK signaling cascade.

• 생물정신의학
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• 제14권3호
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• pp.184-193
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• 2007

목 적: 소뇌가 운동조절 뿐아니라 인지기능과 정신과적 증상에도 중요한 역할을 하고있다는 증거들은 많다. 정신분열병에서 소뇌기능은 많은 연구들에서 대뇌고위기능의 조정곤란(Cognitive dysmetria)이라는 개념을 통해 주목 받아왔다. 다시말하면, 전전두엽-소뇌-시상핵-전전두엽 회로의 이상은 정신분열병에서 인지기능의 손상과 임상증상으로 나타날 수 있는 것이다. 본 연구의 주 목적은 남자 정신분열병 환자에서 소뇌기능이상을 ICARS를 통해 반정량적으로 평가하고, 이것이 임상 및 인지기능과 어떤 연관성이 있는지 알아보는 것이다. 방 법: 저자들은 DSM-IV-TR 진단기준에 따라 정신분열병으로 진단된 47명의 남자 정신분열병 환자와 이와 성별과 나이를 맞춘 건강한 대조군 30명을 소뇌의 신경학적 징후를 ICARS로 점수화하여 비교하였다. 반정량적으로 100점의 총점을 가진 ICARS는 자세와 보행, 사지운동기능, 언어장애, 안구운동장애의 4개의 구획으로 나뉜 19개 항목으로 구성되어 있다. 모든 실험군은 한국형 간이정신상태검사(K-Mini Mental status examination, MMSE), 언어유창성 검사(Verbal fluency test), 시계그림검사(Clock drawing test)를 통해 인지기능검사를 받았다. 환자군에서 임상증상의 심각도는 한국형 양성 및 음성 증상 척도Positive and Negative Symptom Scale(PANSS)로 평가하였다. 환자군에서 ICARS의 높은 점수가 추체외로증상이나 지발성운동장애와 같이 약물사용으로 인한 부작용과 관련이 있는지 여부를 확인하기위하여 Abnormal Involuntary Movement Scale(AIMS)를 시행하였다. 실험군과 변수들에서 통계적 유의성을 보기위해 독립표본 t 검증과 편상관분석을 사용하였다. 결 과: 정신분열병 환자들은 대조군에 비해 ICARS-자세와 보행장애, 운동기능, 안구운동장애-에서 유의하게 높은 점수를 보였다. 환자들은 인지기능검사에서도 보다 심각한 손상을 보였다. ICARS 점수와 PANSS로 평가한 환자들의 음성증상 총점과는 유의한 상관관계가 있었으며, 인지기능검사에서는 시계그림검사, 언어유창성 검사가 음성증상과 유의하게 연관이 있었다. 또, 시계그림검사는 ICARS 점수와 연관이 있었다. 정신분열병 환자에서 발병연령, 유병기간 및 AIMS 점수가 줄수있는 혼란변수는 회귀분석을 사용하여 평가하였으며, AIMS 점수는 ICARS의 점수와 연관성을 보이지 않았다. 결 론: 정신분열병은 발달학적 혹은 신경발달학적 질환으로 개념 내려지고 있다. 대부분의 연구자들은 정신분열병을 가진 환자들이 대뇌고위기능의 조정곤란(Cognitive dysmetria)이라고 불리는 전전두엽-시상핵-소뇌회로의 이상으로 인해 고통받고 있다고 하였다. 본 연구에서 저자들은 정신분열병 환자들이 인지기능과 소뇌기능에서 심각한 손상을 가지고 있고, 특히 이것은 환자들의 음성증상의 정도와 상관관계가 있다는 것을 확인하였다. 이 결과는 정신분열병에서 소뇌의 역할에 대해 지지하고 있다. 또, 정신분열병 환자들의 연성신경학적 징후를 평가하는데 있어 ICARS라는, 구조화되어 다른 검사자들에게도 통용될 수 있는 도구를 사용했다는 것에서 의미가 있다고 볼 수 있겠다. 향후 유사한 연구에서는 질병의 경과에 따라 신경학적 징후의 변화에 대해 설명할 수 있기를 기대한다.

• 대한본초학회지
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• 제22권4호
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• pp.51-58
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• 2007

Objectives : Investigation of the memory and cognitive enhancing effect of HT008-1 in scopolamine induced amnesia mice. Methods : At 60 min before acquisition trials, HT008-1 (30, 100, 300 mg/kg p.o.) was administered, and 30 min later, mice were injected with scopolamin (1.0 mg/kg, i.p.). In the passive avoidance test, acquisition trials were carried out 30 min after a single scopolamine treatment. Retention trials were carried out 24h after acquisition trials. Y-maze test was carried out 30 min after a single scopolamine treatment. Spontaneous alternation behavior during an 8-min session was recorded. Inhibitory effects of HT008-1 (0.01, 0.1, 1.0 mg/ml) on AChE activity was measured. Result : HT008-1 ameliorated scopolamine-induced learning impairments and spatial cognitive function in passive avoidance and Y-maze test, respectively. Moreover HT008-1 showed a significant inhibitory effect on AChE activity. Discussion: This study presented that eMultiherb mixture HT008-1 enhanced learning memory and spatial cognitive function in scopolamine-induced amnesia mice. These results suggest that the effect of HT008-1 may be dependent on the inhibition of AChE activity.

• 대한간호학회지
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• 제44권4호
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• pp.351-360
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• 2014

Purpose: This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF). Methods: Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above. Results: The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption. Conclusion: Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.

• The Korean Journal of Physiology and Pharmacology
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• 제21권1호
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• pp.55-64
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• 2017

Progressive memory impairment such as that associated with depression, stroke, and Alzheimer's disease (AD) can interfere with daily life. In particular, AD, which is a progressive neurodegenerative disorder, prominently features a memory and learning impairment that is related to changes in acetylcholine and abnormal ${\beta}$-amyloid ($A{\beta}$) deposition in the brain. In the present study, we investigated the effects of dehydroevodiamine HCl (DHED) on cognitive improvement and the related mechanism in memory-impaired rat models, namely, a scopolamine-induced amnesia model and a $A{\beta}_{1-42}$-infused model. The cognitive effects of DHED were measured using a water maze test and a passive avoidance test in the memory-impaired rat models. The results demonstrate that DHED (10 mg/kg, p.o.) and Donepezil (1 mg/kg, p.o.) ameliorated the spatial memory impairment in the scopolamine-induced amnestic rats. Moreover, DHED significantly improved learning and memory in the $A{\beta}_{1-42}$-infused rat model. Furthermore, the mechanism of these behavioral effects of DHED was investigated using a cell viability assay, reactive oxygen species (ROS) measurement, and intracellular calcium measurement in primary cortical neurons. DHED reduced neurotoxicity and the production of $A{\beta}$-induced ROS in primary cortical neurons. In addition, similar to the effect of MK801, DHED decreased intracellular calcium levels in primary cortical neurons. Our results suggest that DHED has strong protective effects against cognitive impairments through its antioxidant activity and inhibition of neurotoxicity and intracellular calcium. Thus, DHED may be an important therapeutic agent for memory-impaired symptoms.

• 대한물리의학회지
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• 제17권3호
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• pp.51-58
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• 2022

PURPOSE: This study aimed to evaluate the correlation between executive function and gait evaluations for the elderly, and validate the obstacle gait evaluation as a cognitive impairment test tool. METHODS: This study was a cross-sectional design. 79 people aged 65 years or older were selected as subjects. The Korean version of the Mini-Mental State Examination (MMSE-KC) to evaluate overall cognitive function and the Trail Making Test (TMT) A, B to measure executive function were performed. The 4-meter walking speed test and the walking speed test while crossing over an obstacle were carried out to evaluate gait. The Spearman's correlation was used to measure the correlation between cognition and gait speed. RESULTS: There was no significant correlation between the 4 m gait speed and executive function( TMT-A (p = .056), TMT-B (p = .115)). However, there was a significant correlation between the 4 m gait speed and MMSE-KC (r = .277, p < .05). There was also a significant correlation between walking speed while crossing over an obstacle and all tests (MMSE-KC (r = .382, p < .01). TMT-A (r = -.327, p < .01), TMT-B (r = -.283, p < .05)). CONCLUSION: It was found that the gait speed while crossing over an obstacle was correlated with all cognitive function tests. Therefore, we suggest the use of the gait speed test while crossing over an obstacle rather than the simple gait test to diagnose cognitive decline.

• 재활치료과학
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• 제8권3호
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• pp.43-55
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• 2019

목적: 본 연구의 목적은 수행기반 인지기능 평가를 위한 예비연구로써 노인의 인지기능 저하 선별하기 위해 사용되는 수행기반 인지기능 평가도구를 분석하여 평가 문항을 구성하고 정상 노인을 대상으로 검사를 시행하여 타당도를 검증하는 것이다. 연구방법: 수행기반 인지기능 평가항목을 선정한 후, 만 65세 이상 정상 노인 9명을 대상으로 평가를 시행하였다. 평가도구의 신뢰도를 검증하기 위해 수집된 자료를 대상으로 내적 일관성을 분석하였으며, 공인 타당도를 검증하기 위해 기존 수행기반 인지기능 평가와 MMSE-K와의 상관관계를 분석하였다. 결과: Performance-Based Cognitive Function Test(PCFT)의 내적일치도 Cronbach's ${\alpha}$ 계수는 운동과제 .871 인지과제 .959 높은 신뢰도를 나타냈다. 공인타당도는 운동-인지 이중과제 평가를 이용하여 PCFT의 항목별 상관관계는 .755~.964으로 산출되었으며 통계적으로 유의하였다(p<.05). 또한 인지평가도구인 MMSE와의 상관관계는 .849~.943(p<0.01)로 나타나 높은 타당도를 보였다. 결론: 본 연구를 통해 수행기반 인지기능 평가의 신뢰도 및 타당도를 검증하였다. 추후 연구에서는 최종적으로 수정 보완된 인지기능저하 노인을 선별을 위한 수행기반 인지기능 평가도구를 대상으로 기타 신뢰도 및 타당도를 검증하여야 할 것으로 사료된다.