• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• Health Policy and Management
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• v.26 no.1
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• pp.39-50
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• 2016

Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

• Biomolecules & Therapeutics
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• v.19 no.2
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• pp.224-230
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• 2011

In order to develop silk peptide (SP) preparations possessing cognition-enhancing effect, several candidates were screened through in vitro assays, and their effectiveness was investigated in facilitated brain aging model rats. Incubation of brain acetyl-cholinesterase with SP-PN (1-1,000 ${\mu}g/ml$) led to inhibition of the enzyme activity up to 35%, in contrast to a negligible effect of SP-NN. The expression of choline acetyltransferase (ChAT) mRNA of neural stem cells expressing ChAT gene (F3.ChAT) was increased by 24-hour treatment with 10 and 100 ${\mu}g/ml$ SP-NN (1.35 and 2.20 folds) and SP-PN (2.40 and 1.34 folds). Four-week subcutaneous injections with D-galactose (150 mg/kg) increased activated hippocampal astrocytes to 1.7 folds (a marker of brain injury and aging), decreased acetylcholine concentration in cerebrospinal fluid by 45-50%, and thereby impaired learning and memory function in passive avoidance and water-maze performances. Oral treatment with SP preparations (50 or 300 mg/kg) for 5 weeks from 1 week prior to D-galactose injection exerted recovering activities on acetylcholine depletion and brain injury/aging as well as cognitive deficit induced by D-galactose. The results indicate that SP preparations restore cognitive functions of facilitated brain aging model rats by increasing the release of acetylcholine, in addition to neuroprotective activity.

• Journal of Biomedical Engineering Research
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• v.35 no.4
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• pp.95-98
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• 2014

The baroreflex is one kind of homeostatic mechanisms to regulate acute blood pressure (BP) changes by controlling heartbeat interval (HBI). To quantify the effect of baroreflex, we suggested a new approach of analyzing Granger causality between systolic BP (SBP) and HBI. The index defined as baroreflex effectiveness (BRE) was generated by the hypothesis that more effectual baroreflex would be related to more effective Granger causal influence of SBP on HBI. Six obstructive sleep apnea (OSA) patients (apnea-hypopnea index, AHI ${\geq}5$ events/hr) and six normal subjects participated in the study. Their SBP and HBI during nocturnal sleep were obtained from a non-invasive continuous BP measurement device. While the BRE ($mean{\pm}SD$) of normal subjects was $47.0{\pm}4.0%$, OSA patients exhibited the BRE of $34.0{\pm}3.8%$. The impaired baroreflex function of OSA patients can be explained by the physiological mechanism associated with recurrent hypoxic episodes during sleep. Thus, the significantly lower BRE in OSA patients verified the availability of Granger causality analysis to evaluate baroreflex during sleep. Furthermore, the range of BRE obtained from normal subjects was not overlapped with that obtained from OSA patients. It suggests the potential of BRE as a new helpful tool for diagnosing OSA.

• Journal of Preventive Medicine and Public Health
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• v.40 no.2
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• pp.162-168
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• 2007

Objectives : This prospective population-based cohort study was conducted to evaluate the risk factors of cognitive impairment and the degree of cognitive function change through a 5-year follow-up. Methods : The baseline and follow-up surveys were conducted in 1998 and 2003, respectively, Among 176 subjects who had normal cognitive function in the baseline study, 136 were followed up for 5 years. The cognitive function was investigated using the Korean version of the Mini-Mental State Examination (MMSE-K). The collected data were analyzed using SPSS and Stata. Results : Of the 136 subjects analyzed, 25 (18.4%) were cognitively impaired. Old age and low social support in the baseline survey were risk factors for cognitive impairment after 5 years. In the generalized estimating equation for 128 subjects except severe cognitive impairment about the contributing factors of cognitive function change, the interval of 5 years decreased MMSE-K score by 1.02 and the cognitive function was adversely affected with increasing age, decreasing education and decreasing social support. Conclusions : Although the study population was small, it was considered that the study results can be used to develop a community-based prevention system for cognitive impairment.

• 한국노년학
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• v.40 no.3
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• pp.443-458
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• 2020

Aim: This study investigated the association between leisure activities and cognitive impairment in Korean community-dwelling older adults. Methods: Among participants of the 2017 National Survey of Older Koreans, 10,055 (male=4,277, female=5,778) were included in this cross-sectional study. To better identify the association between late-life cognition and leisure activities, individual leisure activities were categorized into 3 types including productive, consumptive, and unclassified activities. Multivariate logistic regression analysis was performed to assess the association between participation in leisure activities and cognitive impairment when controlling for possible covariates evidenced by previous studies. Results: Male participants were more likely to be cognitively impaired than female ones with significant differences in all the covariates. After controlling for confounding variables, involvement in productive leisure activities was found to be associated with cognitive function in both male and female groups, along with age, educational level, depressive symptoms, subjective hearing problems, and occupational status. Conclusion: Involvement in productive leisure activities might be associated with decreased risk of cognitive impairment in later life. Appropriate strategies to encourage older adults to participate in productive leisure activities should be established to help them maintain their cognitive function.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.41-48
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• 2023

PURPOSE: Falls are caused by a decline in physical and cognitive function. A quantitative evaluation tool that can comprehensively evaluate motor and cognitive functions for elderly people with an impaired physical function. This study assessed the clinical application potential by confirming the correlation between the physical function tests, cognitive and the stepping trail-making test (S-TMT). METHODS: Fourteen community-dwelling older patients (65-75 years) were recruited. The study conducted cognitive function tests with the trail-making test (TMT-A, B), and physical function tests (6-minute walking test (6MWT), short physical performance battery (SPPB), and timed up and go (TUG)). The results of were analyzed using SPSS version 21.0. Descriptive statistics were used for the general characteristics of the study subjects, and the correlations between S-TMT, other functional tests were examined through Pearson's correlation analysis. The statistical significance was set to .05. RESULTS: S-TMT had a significant positive correlation with the TUG (r = .588^*) and trail-making test-B (TMT-B) (r = .689^*, p < .05). Furthermore, S-TMT showed a negative correlation between SPPB (r = -.397) and 6MWT (r = -.422), but it was not statistically significant. CONCLUSION: S-TMT is a cognitive-gait dual-task performance evaluation tool that can be performed safely. A significant correlation was confirmed between the TUG test and the TMT-B. S-TMT is a dual-task screening tool that can evaluate both physical and cognitive functions simultaneously.

• Journal of dental hygiene science
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• v.19 no.4
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• pp.245-253
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• 2019

Background: This study aimed to analyze correlations between depression, cognitive function, oral health state, ability to perform activities of daily living, oral dryness symptoms, and oral health-related quality of life, and determine factors influencing the latter. Methods: This was a cross-sectional study based on questionnaires completed by 260 participants with suspected dementia, residing in South Korea. Psychiatrists, psychiatric nurses, and dental hygienists visited clinics in the participating regions for examination and questionnaire administration. General characteristics, the geriatric depression scale, ability to perform activities of daily living, cognitive function, oral health state, and oral health-related quality of life were analyzed. Independent t-tests, one-way analysis of variance (ANOVA), correlation analysis and multiple regression analysis were conducted, identifying factors affecting oral health-related quality of life. Data analysis was performed using SPSS ver. 20.0 (IBM Corp., USA), and the significance was set at p<0.05. Results: Approximately 65.0% of participants were female, 63.5% were in their 70s, and 90.0% had health insurance. About 21.5%, 42.0%, and 36.5% were normal, slightly impaired, and had dementia, respectively. High cognitive impairment was associated with poor oral health. Sex, education levels, marital status, and living arrangements influenced oral health-related quality of life. According to the regression analysis, geriatric depression and oral dryness affected the Geriatric Oral Health Assessment Index scores. Conclusion: In conclusion, oral dryness and depression levels among elders influenced oral health-related quality of life. The results showed that to enhance elders' oral health-related quality of life, it is essential to not only improve their oral health state, but also relieve oral health problems, especially oral dryness, and take into consideration their psychological aspects.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.11
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• pp.1691-1694
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• 2010

In the present study, we assessed whether the extracts of Codonopsis lanceolata and fermented C. lanceolata posses the cognition-enhancing effect in rats with impaired learning and memory by scopolamine treatment (1 mg/kg, i.p.), an antagonist of muscarinic acetylcholine (ACh) receptor. The fermented C. lanceolata extract (333, 667 mg/kg) significantly reversed the scopolamine-induced cognitive impairments in the passive avoidance test (p<0.05). Moreover, fermented C. lanceolata extract (333 mg/kg) also improved escape latencies in training trials of Morris water maze test (p<0.05). The water extract of fermented C. lanceolata showed significant anti-amnestic and cognitive-enhancing activities related to the memory processes, and these activities were parallel to treatment duration and dependent of the learning models.

• Korean Journal of Cognitive Science
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• v.24 no.3
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• pp.271-300
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• 2013

Human and animals are born with an intuitive ability to determine approximate numerosity. This ability is termed approximate number sense (hereafter, number sense). Evolutionarily, number sense is thought to be an essential ability for hunting, gathering and survival. According to previous research, children with mathematical learning disability have impaired number sense. On the other hand, individuals with more accurate number sense have higher mathematical achievement. These results support the hypothesis that number sense provides a basis for the development of mathematical cognition. Recently, researchers have been examining whether number sense training can lead to enhancement in mathematical achievement and changes in brain activity in relation to mathematical problem solving. Numerosity which basically represents discontinuous quantity is expected to be closely related to continuous quantity such as representations of space and time. A theory of magnitude (ATOM) states that processing of number, space and time is based on a common magnitude system in the posterior parietal cortex, especially the intraparietal sulcus. The present paper introduces current literature and future directions for the study of the common magnitude system.