• Sleep Medicine and Psychophysiology
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• v.21 no.1
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• pp.5-13
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• 2014

Objectives: Depression, sleep complaints and cognitive impairments are commonly observed in the elderly. Elderly subjects with depressive symptoms have been found to show both poor cognitive performances and sleep disturbances. However, the relationship between sleep complaints and cognitive dysfunction in elderly depression is not clear. The aim of this study is to identify the association between sleep disturbances and cognitive decline in late-life depression. Methods: A total of 282 elderly people who underwent nocturnal polysomnography in a sleep laboratory were enrolled in the study. The Korean version of the Neuropsychological Assessment Battery developed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was applied to evaluate cognitive function. Depressive symptoms were assessed with the geriatric depression scale (GDS) and subjective sleep quality was measured using the Pittsburg sleep quality index (PSQI). Results: The control group ($GDS{\leq}9$) when compared with mild ($10{\leq}GDS{\leq}16$) and severe ($17{\leq}GDS$) depression groups, had significantly different scores in the Trail making test part B (TMT-B), Benton visual retention test part A (BVRT-A), and Stroop color and word test (SCWT)(all tests p<0.05). The PSQI score, REM sleep duration, apnea-hypopnea index and oxygen desaturation index were significantly different across the three groups (all indices, p<0.05). A stepwise multiple regression model showed that educational level, age and GDS score were predictive for both TMT-B time (adjusted $R^2$=35.6%, p<0.001) and BVRT-A score (adjusted $R^2$=28.3%, p<0.001). SCWT score was predicted by educational level, age, apnea-hypopnea index (AHI) and GDS score (adjusted $R^2$=20.6%, p<0.001). Poor sleep quality and sleep structure alterations observed in depression did not have any significant effects on cognitive deterioration. Conclusion: Older adults with depressive symptoms showed mild sleep alterations and poor cognitive performances. However, we found no association between sleep disturbances (except sleep apnea) and cognitive difficulties in elderly subjects with depressive symptoms. It is possible that the impact of sleep disruptions on cognitive abilities was hindered by the confounding effect of age, education and depressive symptoms.

• Horticultural Science & Technology
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• v.28 no.5
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• pp.884-890
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• 2010

To examine the effects of horticultural occupational therapy (HOT) on the physical and psychological rehabilitation of stroke patients with paralysis on one side of the body, a horticultural therapy (HT) program was implemented along with occupational therapy (OT) in 20 patients with hemiplegia after stroke (treatment group). In the control group, another 20 patients with hemiplegia after stroke received OT but no HT. The HOT program consisted of various indoor horticultural activities that proceeded stepwise on a weekly basis over the course of four weeks. The selected horticultural occupations were organized into four-phases: motivation, adaptation, sociality, and interpersonal relationships and communication. The grooved pegboard test (GPT), geriatric depression scale (GDS), and functional independent measure (FIM) were tested to the patients in this study. Unlike control group, the treatment group showed statistically significant differences in GPT, GDS, and FIM ($p$<0.001). In addition, communication, social cognition, and self-care scores as FIM subordinate factors were improved significantly by HOT program which motivated patients to engage in rehabilitation therapy. This finding suggests that HOT has the potential to be used as an OT program for stroke patients with hemiplegia.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.129-135
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• 2017

Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

• Journal of Music and Human Behavior
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• v.12 no.1
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• pp.43-64
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• 2015

This study investigated the effects of song discussion on depression and rehabilitation motivation in stroke patients. Older adults with chronic stroke participated in this study: nine for the experimental group and eight for the control group. The experimental group was divided into three subgroups and participated in 12 sessions over 6 weeks. Target lyrics were selected by the investigator among popular songs from the participants' young adulthood. The song-based discussion was facilitated to address issues targeted at supportive, insight-focused, or reconstructive stage. The control group was provided with delayed intervention. At pre and posttest, the short form of Geriatric Depression Scale and the Rehabilitation Motivation Scale were measured. The experimental group showed significantly decreased depression and significantly increased rehabilitation motivation (p < .01), while the control group showed no significant changes. Positive changes were also observed in all subcategories of rehabilitation motivation in the experimental group, particularly in significantly increased task-oriented motivation and decreased amotivation. This study suggests that song discussion will be effectively applied in rehabilitative settings to address psychological issues of older adults with stroke.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.440-449
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• 2020

This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.72-80
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• 2020

Objectives : The aim of this study was to compare the effect of Selective Serotonin Reuptake Inhibitor (SSRI) and Serotonin Norepinephrine Reuptake Inhibitor (SNRI) for mood symptoms, pain, and somatic symptoms in elderly depression patients with pain and somatic symptoms. Methods : This study is a prospective open-label study conducted by a single institution. A total of 43 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study (average age: 72.53, 58.1% women). The subjects were classified as SSRI and SNRI groups. Depressive symptoms, pain, and somatic symptoms were evaluated by Korean version of the Hamilton Depression Rating Scale (K-HDRS), visual analogue scale (VAS) and Patient Health Questionnare-15 (PHQ-15) respectively at baseline and six weeks later. Two-way repeated-measure ANOVA was performed to analyze changes in the KHDRS, VAS, and PHQ-15 scores. Results : In the SSRI and SNRI groups, K-HDRS, VAS, and PHQ-15 all showed significant improvement after 6 weeks compared to each baseline values. There were no differences in therapeutic effect between the two groups. Conclusions : We found that SSRI and SNRI both improved somatic symptoms and pain in elderly depression patients. The results of this study are thought to help select antidepressants when administering medication to elderly depression patients who complain pain and somatic symptoms. Further research is needed on the longterm effects of the SSRI and SNRI.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.38-45
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• 2017

Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.490-497
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• 2015

The aim of this study was to examine the quality of life (QOL) and its related factors in veterans with physical dysfunction. The survey data was collected from 412 patients with physical dysfunction managed at five veterans' hospitals in Seoul, Pusan, Daegu, Gwangju, and Daejeon city. The baseline for the quality of life was measured using the SF-36 (Short-Form 36), activities of daily living was measured using a Modified Barthel Index (MBI), pain level was determined using Quadruple Visual Analogue Scale (QVAS), and the depression level was assessed using Korean version of the Geriatric Depression Scale: Short-Form (SGDS-K). The SF-36 scores showed a significant correlation with age (r=-0.132), self-rated current health status (r=-0.545), active daily living (r=0.514), pain level (r=-0.243), and depression level (r=-0.565) (p<0.05). The most influential variables on the QOL were the depression level (B=-.969, p<0.001), QVAS (B=-0.163, p<0.001), and MBI (B=0.140, p<0.001). The results of this study showed that that depression, pain and activities of daily living are significant predictors of the QOL in veterans with a physical dysfunction. Therefore, healthcare providers need to consider these parameters for interventions to improve the QOL in veterans with a physical dysfunction.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.759-771
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• 2020

The purpose of this study was to explore the meaning of life in near-poor elderly living alone and experiencing depression. We focused on their lived experiences so that we could understand the essential structure of what kind of life they live. The eligible population included those aged 65 or older, showing 9 points or higher in the Korean form of Geriatric Depression Scale (KGDS), currently living alone for more than 1 year, having no problems of communication difficulties, and nationally defined as a near-poor group. A purposive sample of 8 seniors enrolled in s mental health welfare center in Incheon Metropolitan City were recruited. The phenomenological approach suggested by Colaizzi was used. Data was collected from May 2018 to October 2019 through in-depth interviews. As a result of the study, 6 categories, including 48 themes and 19 theme clusters, were drawn from the data: 'a shabby life that cannot live without help', 'a life where the body and mind are sick', 'a life that wants to be self-reliant', 'a life of gratitude', 'a life with inner peace', and 'a life that needed institutional support.' Findings of this study can be evidence for developing suitable emotional support programs for the near-poor elderly living alone and to enact various welfare laws and policies at the national level.

• Anxiety and mood
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• v.3 no.2
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• pp.128-133
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• 2007

Objective : Obesity has been considered to be associated with numerous physical, mental and psychological diseases. Depression, which is a major psychological factor affecting occurrence and treatment of obesity, can be a cause of obesity as well as can be triggered by obesity. This study aimed to find out the need of positive consideration to the existence of depressive mood in the management of obesity. Methods : A total of 101 subjects were enrolled among those who were 60 years old and over at one local clinic. Obese group (n=49) was defined as BMI${\geqq}$25 and normal weight group (n=52) as 20$5.2{\pm}2.5$) was significantly higher than that of the normal weight group ($3.8{\pm}1.7$)(p<0.05). In male subjects, there was no significant difference in the mean GDSSF-K score between both groups, but in female subjects, the mean GDSSF-K score of the obese group, $6.4{\pm}2.6$ was significantly higher than that of the normal weight group ($4.0{\pm}1.8$)(p<0.05). Conclusion : The elderly obese group showed higher depressive scale score than elderly normal weight group, especially in female elderly. Since the elderly obese female group had a depressive predisposition, comprehensive management including mental and psychological approach is required in obesity control programs.