• Journal of Korean Academy of Nursing
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• v.51 no.3
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• pp.294-304
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• 2021

Purpose: This study aimed to investigate objectively measured physical activity (PA) in institutionalized older adults with mild cognitive impairment (MCI) and to elucidate the influence of autonomic nervous function, salivary cortisol, and PA on cognitive functions based on neurovisceral integration model. Methods: Overall cognitive function was evaluated using the mini-mental state examination (MMSE) and executive function was evaluated using semantic verbal fluency test and clock drawing test. Actigraph for PA, HRV and sAA for autonomous function, and the geriatric depression scale for depression were used. Saliva specimens were collected in the morning for sAA and cortisol. Results: Ninety-eight older adults from four regional geriatric hospitals participated in the study. They took 4,499 steps per day on average. They spent 753.93 minutes and 23.12 minutes on average in sedentary and moderate-to-vigorous activity, respectively. In the multiple regression analysis, lower salivary cortisol level (β = - .33, p = .041) and greater step counts (β = .37, p = .029) significantly improved MMSE score. Greater step count (β = .27, p = .016) also exerted a significant influence on verbal fluency, and greater sAA (β= .35, p = .026) was significantly associated with a better clock drawing test result. Conclusion: Salivary cortisol, sAA and physical activity were significantly associated with cognitive functions. To prevent older adults from developing dementia, strategies are needed to increase their overall PA amount by decreasing sedentary time and to decrease salivary cortisol for cognitive function, and to maintain their sympathetic nervous activity for executive function.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.159-165
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• 2022

Objective: This clinical study describes the effect of Korean medicine on a patient with Delayed Neuropsychiatric Sequelae after Carbon Monoxide Poisoning. Case presentation: A patient with the delayed neuropsychiatric effects of carbon monoxide exposure was treated with herbal medicine, acupuncture, moxibustion, and cupping. Clinical symptoms were measured with the Korean Mini Mental State Examination (K-MMSE), Functional Independence Measure (FIM), and the Modified Barthel Index (MBI). After 32 days of treatment, the patient's K-MMSE score increased from 11 to 21 points, the FIM score from 52 to 94 points, and the MBI score from 46 to 84 points. There were no side effects. Conclusion: According to this case study, Korean medicine may be considered an effective treatment for delayed neuropsychiatric sequelae, although more studies are needed to confirm its validity.

• Journal of People, Plants, and Environment
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• v.23 no.1
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• pp.35-46
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• 2020

The purpose of this study was to investigate the effects of the horticultural therapy program on patients with mild cognitive impairment and mild dementia depending on the frequency and duration of the interventions. We developed the same 15-session program to improve cognitive functions and life satisfaction and alleviate depression of the elderly women with mild cognitive impairment or mild dementia. Subjects in Longer Treatment group participated in the program once a week for 15 weeks and subjects in Shorter Tratmet group participated twice a week for 7½ weeks. This study conducted pretest-posttest verification of both groups using quasi-experimental design involving 21 subjects. Elderly life satisfaction, Geriatric Depression Scale (short form), and the Korean Version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) were used in the evaluation. As a result, both groups showed an increase in life satisfaction, and a decrease in depression. However, there was a significant difference in the changes of the CERAD-K scores between the two groups (p < .05). In Longer Treatment group, life satisfaction increased significantly (p < .001), and depression decreased at a marginally significant level (p = .068), but no statistically significant change was observed in neurocognitive function. In Shorter Treatment group, life satisfaction increased at a marginally significant level (p = .059), and depression and CERAD-K scores decreased significantly (p < .05). However, in the case of Mini-Mental State Examination (MMSE-K), there was no significant change in both groups. According to these results, when planning a horticultural therapy program for persons with mild cognitive impairment or mild dementia, it is effective to organize and execute the program by determining the duration of intervention as 3 to 4 months or longer, even if this reduces the number of interventions per week.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.83-91
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• 2022

Purpose: The goal of this study was to investigate changes in dual-task performance according to age and difficulty of cognitive tasks for the in community-dwelling elderly populations, as well as to examine their changes in hand dexterity according to age and cognitive function. Methods: A total of 135 people aged 65 years old and over participated in the study. To evaluate each participant's dual-task performance, each participant completed a dual task. To assess their cognitive function, the Korean Mini-Mental State Examination (MMSE-K) and the Korean version of Montreal Cognitive Assessment (MoCA-K) were the tools used. Participants were divided into three groups based on their age: 65-69 years, 70-79 years, and 80-89 years. Results: The findings showed that age groups and the difficulty of the cognitive task significantly affected the amount of time required for dual-task performance (p<.001). Additionally, the dual-task correct response rate (CRR) decreased significantly with age groups and the difficulty of the cognitive task (p<.001). The amount of time required for finger dexterity performance increased significantly with age groups (mean score±standard deviation [SD]; 19.46±2.26 in subjects aged 65-69 years; 21.92±2.61 in subjects aged 70-79 years; and 23.82±2.92 in subjects aged 80-89 years; p<.001). Moreover, as a result of the correlation between hand dexterity and cognitive function, MoCA-K was -0.563 and MMSE-K was -.412, showing a statistically significant correlation (p<.001). Conclusions: Age and the difficulty of the cognitive task affect the community-dwelling elderly populations in terms of dual-task performance and dual-task CRR. In addition, aging and general cognition have an impact on hand dexterity. Based on the results of this study, it is anticipated that the results will serve as a reference for domestic clinical trials that confirm cognitive decline in the elderly using dual task and hand dexterity evaluation.

• The Journal of Internal Korean Medicine
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• v.44 no.1
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• pp.66-76
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• 2023

Background: The aim of this study is to investigate the use of heart rate variability on a stroke patient with autonomic dysfunction and the effectiveness of Bunshimgi-eum. Case report: The patient showed autonomic dysfunction, including chest discomfort, 煩燥 (sweating, anxiety, insomnia, nausea, lightheadedness), and abdomen discomfort (dyspepsia, heartburn) after ischemic stroke. She was treated with a herbal medicine (Bunshimgi-eum) through complex Korean medicine treatment. The effect was evaluated using heart rate variability (HRV), Mini-Mental State Examination-DS (MMSE-DS), mean pulse rate, and subjective percentage of symptoms. After treatment, the HRV score, MMSE-DS score, and subjective percentage of symptoms improved, and the pulse rate decreased from the upper boundary value. Discussion: The results suggest that HRV may be useful in evaluating stroke patients with autonomic dysfunction and that Bunshimgi-eum is suitable for treatment.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1274-1288
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• 2022

Objectives: The study investigated the effect of Korean medicine treatment on a hemiplegic patient with conscious and cognitive disorders due to hemorrhagic transformation after interventional reperfusion therapy of anterior circulation infarction. Case presentation: The patient was treated with acupuncture, moxibustion, cupping, and herbal medicine in combination with Western medicine and physical therapy. The effects on clinical symptoms were evaluated using the Manual Muscle Test (MMT), Glasgow Coma Scale (GCS), Korean Mini-Mental State Examination (K-MMSE), Korean Nursing Delirium Screening Scale (Korean Nu-DESC), and Modified Bathel Index (MBI). After the treatment, the MMT grade increased from Gr.0-1 to Gr.0-3, the GCS score increased from 10 to 15, the K-MMSE score increased from 8 to 15, the Korean Nu-DESC score decreased from 3 to 1, night delirium disappeared, and the MBI score increased from 13 to 26. Conclusions: Complex Korean medicine treatments were effective for improving the clinical symptoms of hemorrhagic transformation after interventional reperfusion therapy for anterior circulation infarction in a patient with hemiplegia and conscious and cognitive disorders. However, further studies are needed.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.987-998
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• 2023

The purpose of this case study is to report the effectiveness of scalp acupuncture and Cheungsindodam-tang on Wernicke's aphasia in patients with left middle cerebral territory infarction. Scalp acupuncture, herbal medicine (Cheungsindodam-tang), and moxibustion were administered for 66 days to improve the patient's symptoms. The degree of improvement in symptoms was evaluated using the Korean version of the Western Aphasia Battery (K-WAB) and Mini-Mental State Examination-Korea (MMSE-K). Quality of life was evaluated with the Korean version of the Stroke and Aphasia Quality of Life Scale-39 (K-SAQOL-39). After 66 days of treatment, the aphasia quotient score of the K-WAB test increased from 19 to 34.6 after treatment. The K-SAQOL-3 score increased from 2.77 to 3.18, and the MMSE-K score increased from 4 to 21. This case report suggests that Korean medical therapy can be effective in improving the language functions of patients with Wernicke's aphasia.

• Journal of Ginseng Research
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• v.47 no.6
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• pp.735-742
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• 2023

Background: Gintonin is a new material of ginseng that acts through the ginseng-derived lysophosphatidic acid (LPA) receptor ligand. The gintonin-enriched fraction (GEF) inhibits amyloid plaque accumulation in the cortex and hippocampus, improves cognitive dysfunction by increasing acetylcholine levels, and promoted hippocampal neurogenesis in an animal model of Alzheimer's disease. We evaluated the effect of the GEF on the cognitive performance of subjects with subjective memory impairment (SMI). Methods: In this eight-week, randomized, assessor- and participant-blinded, placebo-controlled study, participants with SMI were assigned to three groups receiving placebo, GEF 300 mg/day or GEF 600 mg/day. The Korean versions of the Alzheimer's Disease Assessment Scale (K-ADAS), Mini-Mental State Examination (K-MMSE), and Stroop color-word test (K-SCWT) were also evaluated along with the safety profiles. Results: One hundred thirty-six participants completed the study. After eight weeks, we analyzed intergroup differences in primary or secondary outcome score changes. When we compared the GEF group with the placebo group, we observed significant improvements in the K-ADAS and K-SCWT scores. The GEF group did not show a significant improvement in K-MMSE and BDI scores compared to the placebo group. No adverse events were observed in the gintonin and placebo groups for eight weeks. Conclusion: The GEF is safe and effective in improving subjective cognitive impairment related to both the K-ADAS and K-SCWT in this study. However, further large-scale and randomized controlled studies are warranted to secure other cognitive function tests besides the K-ADAS and K-SCWT, and to confirm the findings of the current study.

• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.433-444
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• 2023

Objectives: This case study aimed to provide evidence of the combined use of Korean Medicine treatments, including electroacupuncture (EA) on scalp acupoints, as a useful intervention for post-stroke delirium. Methods: The patient in this study was diagnosed with Cerebral Infarction in Right Corpus Callosum and post-stroke delirium. The patient received eight sessions of EA on scalp acupoints, rehabilitation medicine treatment, and other Korean Medicine treatments such as acupuncture and herbal medicine. Evaluation of treatment effectiveness was done mainly through the Memorial Delirium Assessment Scale Korean (MDAS-K) and Mini-Mental State Examination Korean (MMSE-K). Results: MDAS-K score dropped from 20 to 9 and MMSE-K score increased from 15 to 21 during hospitalization, showing improvement in symptoms. Conclusions: Combined use of Korean medicine treatments including EA on scalp acupoints may be an effective treatment for post-stroke delirium.

• Korean Journal of Radiology
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• v.24 no.11
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• pp.1131-1141
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• 2023

Objective: Cortical iron deposition has recently been shown to occur in Alzheimer's disease (AD). In this study, we aimed to evaluate how cortical gray matter iron, measured using quantitative susceptibility mapping (QSM), differs in the clinical cognitive impairment spectrum. Materials and Methods: This retrospective study evaluated 73 participants (mean age ± standard deviation, 66.7 ± 7.6 years; 52 females and 21 males) with normal cognition (NC), 158 patients with mild cognitive impairment (MCI), and 48 patients with AD dementia. The participants underwent brain magnetic resonance imaging using a three-dimensional multi-dynamic multi-echo sequence on a 3-T scanner. We employed a deep neural network (QSMnet+) and used automatic segmentation software based on FreeSurfer v6.0 to extract anatomical labels and volumes of interest in the cortex. We used analysis of covariance to investigate the differences in susceptibility among the clinical diagnostic groups in each brain region. Multivariable linear regression analysis was performed to study the association between susceptibility values and cognitive scores including the Mini-Mental State Examination (MMSE). Results: Among the three groups, the frontal (P < 0.001), temporal (P = 0.004), parietal (P = 0.001), occipital (P < 0.001), and cingulate cortices (P < 0.001) showed a higher mean susceptibility in patients with MCI and AD than in NC subjects. In the combined MCI and AD group, the mean susceptibility in the cingulate cortex (β = -216.21, P = 0.019) and insular cortex (β = -276.65, P = 0.001) were significant independent predictors of MMSE scores after correcting for age, sex, education, regional volume, and APOE4 carrier status. Conclusion: Iron deposition in the cortex, as measured by QSMnet+, was higher in patients with AD and MCI than in NC participants. Iron deposition in the cingulate and insular cortices may be an early imaging marker of cognitive impairment related neurodegeneration.