Comparisons of Cognitive Functions between Urban and Rural Dwelling Older Adults: A Preliminary Study

도시와 농촌거주 노인의 인지기능 비교: 예비연구

  • Kim, Jung Wan (Dept. of Speech Pathology, College of Rehabilitation Sciences, Deagu University) ;
  • Kang, Yeonwook (Dept. of Psychology, College of Social Sciences, Hallym University) ;
  • Yoon, Ji Hye (Dept. of Speech Pathology and Audiology, Audiology and Speech Pathology Research Institute, College of Natural Sciences, Hallym University)
  • 김정완 (대구대학교 언어치료학과) ;
  • 강연욱 (한림대학교 심리학과) ;
  • 윤지혜 (한림대학교 언어청각학부)
  • Received : 2016.11.25
  • Accepted : 2017.04.20
  • Published : 2017.04.28


Mini-Mental State Examination (MMSE) and naming tests have been used clinically as screening and diagnostic tools for mild cognitive impairment and dementia. Researches in other countries have reported that residential areas would affect one's cognitive abilities. In Korean, however, there was no systematic studies on geographical influences to cognitive ability among a sample of urban/rural residents. The aim of this study was to investigate the effect of urban/rural locality of residence on cognitive tests in normal elderly Korean. Residents aged 65 years and older (N=108) were administered the K-MMSE, confrontation/generative naming tests, and medical/socio-demographic interview. When comparing the total number of correct responses between urban residents and rural residents, the performances of rural group were significantly worse than those of the urban group in K-MMSE. Based on the results, our finding suggests that a factor of residential locality should be considered to examine the function and explain the cognitive decline in rural community-dwelling elders.


Elderly;Cognitive function;Naming;Urban;Rural


Supported by : 한국연구재단


  1. M. Y. Chong, C. C. Chen, H. Y. Tsang, T. L. Yeh, C. S. Chen, Y. H. Lee, et al., "Community study of depression in old age in Taiwan: Prevalence, life events and socio-demographic correlates." British journal of psychiatry, Vol. 178, No. 1, pp. 29-35, 2001.
  2. B. J. Hahm, J. K. Kim, M. J. Cho, "Prevalence, incidence, and risk factors of dementia and depressive disorders of the elderly residing in the community: a two stage one-year follow-up study." Journal of Korean geriatric psychiatry, Vol. 3, No. 2, pp. 140-148, 1999.
  3. J. Woo, S. C. Ho, J. Lau, Y. K. Yuen, H. Chiu, H. C. Lee, I. Chi, "The prevalence of depressive symptoms and predisposing factors in an elderly Chinese population." Acta psychiatrica Scandinavica, Vol. 89, No. 1, pp. 8-13, 1994.
  4. E. S. Paykel, R. Abbott, R. Jenkins, T. S. Brugha, H. Meltzer, "Urban-rural mental health differences in Great Britain: findings from the National Morbidity Survey." Psychological medicine, Vol. 30, No. 2, pp. 269-280, 2000.
  5. D. B. Mumford, F. A. Minhas, I. Akhtar, S. Akhter, M. H. Mubbashar, "Stress and psychiatric disorder in urban Rawalpindi. Community survey." British journal of psychiatry, Vol. 177, pp. 557-562, 2000.
  6. B. Nunes, R. D. Silva, V. T. Cruz, J. M. Roriz, J. Pais, M. C. Silva, "Prevalence and pattern of cognitive impairment in rural and urban populations from Northern Portugal." BMC neurology, Vol. 10, pp. 42, 2010.
  7. R. J. Ivnik, J. F. Malec, G. E. Smith, E. G. Tangelos, R. C. Petersen, E. Kokmen, L. T. Kurland, "Mayo's older American normative studies." The clinical neuropsychologist, Vol. 6 (suppl), pp. 1-104, 1992.
  8. J. Nadler, W. Mittenberg, F. A. DePiano, B. A. Schneider, "Effect on patient age on neuropsychological test interpretation." Professional psychology: research and practice, Vol. 25, No. 3, pp. 288-295, 1994.
  9. Y. Stern, H. Andrews, J. Pittman, M. Sano, T. Tatemichi, R. Lantigua, R. Mayeux, "Diagnosis of dementia in a heterogenous population." Archives of neurology, Vol. 49, No. 5, pp. 453-460, 1992.
  10. A. M. Bernice, A. M. Carol, J. G. "Anthony, Cognitive impairment or inadequate norms? A study of healthy, rural, older adults with limited education." The Clinical Neuropsychologist, Vol. 11, No. 2, pp. 111-131, 1997.
  11. B. J. Gurland, "The borderlands of dementia: The influence of sociocultural characteristics on rates of dementia occurring in the senium. In N. E. Miller, G. D. Cohen (Eds.), Clinical aspects of Alzheimer's disease and senile dementia." New York: Raven Press, pp. 61-84, 1981.
  12. S. M. Cordes, "The changing rural environment and the relationship between health services and rural development." Health services research, Vol. 23, No. 6, pp. 757-784, 1989.
  13. K. H. Chung, Y. H. Oh, J. E. Seok, S. R. Do, C. W. Kim, Y. K. Lee, H. K. Kim, "The living profiles and welfare service needs of older persons in Korea, 2004." Seoul: Korean Institute for Health and Social Affairs, Ministry of Health Welfare, pp. 22-24, 2005.
  14. J. D. Chun, S. Y. Ryu, M. A. Han, J, Park, "Comparisons of Health Status and Health Behaviors among the Elderly between Urban and Rural Areas." J Agric Med Community Health, Vol. 38, No. 3, pp. 182-194, 2013.
  15. J. M. Kim, I. S. Shin, J. S. Yoon, R. Stewart, "Prevalence and correlates of late-life depression compared between urban and rural populations in Korea." International journal of geriatric psychiatry, Vol. 17, No. 5, pp. 409-415, 2002.
  16. M. F. Folstein, S. E., Folstein, P. R. McHugh, "Mini-Mental State": a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, Vol. 12, pp. 189-198, 1975.
  17. M. Nicholas, C. Barth, L. K. Obler, R. Au, M. L. Albert. "Naming in normal aging and dementia of the Alzheimer's type." In: H. Goodglass, A. Wingfield, editors. Anomia: neuroanatomical and cognitive correlates. San Diego: Academic Press; pp. 166-188, 1997.
  18. Y. W. Kang, "A normative study of the Korean-Mini Mental State Examination (K-MMSE) in the elderly." Korean Journal of Psychology, Vol. 25, No. 2, pp. 1-12, 2006.
  19. K. J. Christensen, K. S. Multhaup, S. Nordstrom, K. Voss, "A cognitive battery for dementia: Development and measurement characteristics." Psychological assessment, Vol. 3, No. 2, pp. 168-174, 1991.
  20. B. S. Ki, "A preliminary study for the standardization of geriatric depression scale short form-Korea version." Journal of the Korean Neuropsychiatric Association, Vol. 35, No. 2, pp. 298-307, 1996.
  21. H. Kim, D. L. Na. "Korean-Boston Naming Test (K-BNT)." Seoul: Hakjisa, 1997.
  22. D. F. Benson, A. Ardila, "Aphasia: A clinical perspective." New York: Oxford University Press, 1996.
  23. E. Capitani, M. Laiacona, R. Barbarotto, "Gender affects word retrieval of certain categories in semantic fluency tasks." Cortex, Vol. 35, No. 2, pp. 273-278, 1999.
  24. J. W. Kim, J. H. Hwang, S. R. Kim, H. Kim, "Differences in attention and naming ability with age in the elderly." Journal of Speech-Language & Hearing Disorders, Vol. 22, No. 3, pp. 25-44, 2013.
  25. G. E. Gomez, E. A. Gomez, "Depression in the elderly." J Psych Nur, Vol. 31, No. 5, pp. 28-33, 1993.
  26. K. Walters, E. Breeze, P. Wilkinson, G. M. Price, C. J. Bulpitt, A. Fletcher, "Local area deprivation and urban-rural differences in anxiety and depression among people older than 75 years in Britain." American journal of public health, Vol. 94, No. 10, pp. 1768-1774, 2004.
  27. C. H. Shin, S. Y. Kim, Y. S. Lee, Y. C. Cho, T. Y. Lee, D. B. Lee, "A study on the factors related to the cognitive function and depression among the elderly." Korean Journal of Preventive Medicine, Vol. 29, No. 2, pp. 199-214., 1996.
  28. M. Ganguli, G. Ratcliff, F. Huff, S. Belle, M. Kancel, L. Fischer, E. C. Seaberg, L. H. Kuller, "Effects of age, gender, and education on cognitive tests in a rural elderly community sample: norms from the monongahela valley independent elders survey." Neuroepidemiology, Vol. 10, No. pp. 42-52, 1991.
  29. R. L. Roger, J. S. Meyer, K. F. Mortel, "After reaching retirement age, physical activity sustains cerebral perfusion and cognision." Journal of the American Geriatrics Society, Vol. 38, No. 2, pp. 123-128, 1990.
  30. N. Scarmeas, G. Levy, M. Tang, J. Manly, Y. Stern, "Influence of leisure activity on the incidence of Alzheimer's disease." Neurology, Vol. 57, No. 12, pp. 2236-2242, 2001.
  31. F. A. Sorond, D. M. Schnyer, J. M. Ferrador, W. P. Milberg, L. A. Lipsitz, "Cerebral blood flow regulation during cognitive tasks: effects on healthy aging." Cortex, Vol, 44, No. 2, pp. 179-184, 2008.
  32. S. Y. Kim, S. K, Paek.. " The effect of combined cognitive-motor learning program with mild cognitive impairment elderly patients." Journal of Digital Convergence, Vol. 13, No. 10, pp. 587-595, 2015.
  33. M. J. Kim, J. S. Han, M. J. Kwon, Y. H. Kim. "The correlation between cognition and depression of urban and rural elderly people." Journal of Digital Convergence, Vol. 11, No. 2, pp. 341-346, 2013.
  34. O. H. Ahn, H. K Cha, S. J. Chang, H. S, Kim, E. H, Chang. "Factors affecting successful aging in rural elderly people." Journal of Digital Convergence, Vol .11, No. 11, pp. 499-508, 2013.
  35. Y. S., Kwon, K. S. Baek. "Factors associated with cognitive decline in the elderly in community." Journal of Digital Convergence, Vol. 12, No. 2, pp. 587-594, 2014.
  36. Y. H. Ko. "The relationships among the physical competence, subjective health status, and health promoting behavior of elderly participating in health activity program." Journal of Digital Convergence, Vol. 14, No. 12, pp. 571-581, 2016.
  37. B. H. Chung. "The effect of cognitive occupational therapy in community living elders with mild cognitive impairment and dementia." Journal of Digital Convergence, Vol. 11, No. 3, pp. 317-325, 2013.
  38. J. S, Lee, S. Y. Lee. "Effects of Cognitive Function and Depression on Anxiety in Elderly People-Convergent approach." Journal of Digital Convergence, Vol. 13, No. 8, pp. 401-408, 2015.
  39. J. E. Graham, K. Rockwood, B. L. Beattie, R. Eastwood, S. Gauthier, H. Tuokko, I. Mc Dowell, "Prevalence and severity of cognitive impairment with and without dementia in an elderly population." Lancet, Vol. 349, No. 9068, pp. 1793-1796, 1997.