• Journal of the Korean Medical Association
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• v.61 no.12
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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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• v.9 no.2
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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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• v.63 no.6
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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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• v.47 no.4
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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.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.184-193
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• 2007

Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

• The Korea Journal of Herbology
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• v.22 no.4
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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.

• Journal of Korean Academy of Nursing
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• v.44 no.4
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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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• v.21 no.1
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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.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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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.

• Therapeutic Science for Rehabilitation
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• v.8 no.3
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• pp.43-55
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• 2019

Objective: The purpose of this study is to conduct a preliminary research for the development of a Performance-Based Cognitive Function Test (PCFT) to screen the elderly for cognitive function impairment, and examine the reliability and validity of the test. Methods: A draft version of the Performance-Based Cognitive Function Test (PCFT) was developed and utilized in nine healthy elderly individuals. In order to verify its reliability, we analyzed the internal consistency of the PCFT. In order to verify the concurrent validity of the PCFT, this study analyzed the correlation between motor-cognitive dual task assessments and the Korean version of the Mini-Mental State Examination (MMSE-K). Results: The internal consistency of the PCFT for motor and cognitive tasks was 0.871 and 0.959 (Cronbach's ${\alpha}$), respectively. Concurrent validity of the PCFT, which was performed through motor-cognitive dual task assessments, ranged from 0.755 to 0.964 (Spearman's rho statistic, p < 0.05). In addition, correlation between the cognitive assessment tool and the MMSE-K ranged from 0.849 to 0.943 (p < 0.01). Conclusion: This study verified, and established the reliability and validity of the PCFT. Further studies are required to examine other psychometric properties in a modified PCFT, for screening cognitive function impairments in the elderly.