• 대한간호학회지
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• 제51권3호
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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.

• 한국산학기술학회논문지
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• 제16권5호
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• pp.3344-3352
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• 2015

본 연구는 외상성 뇌손상 환자를 대상으로 한국형 전산화 인지재활프로그램(CoTras)이 전두엽-집행기능에 미치는 효과를 알아보고자 하였다. 2013년 8월부터 2014년 3월까지 경남 창원에 위치하는 C병원에 내원한 외상성 뇌손상 환자 10명을 두 그룹으로 무작위 할당한 후 실험군에게 한국형 전산화 인지재활프로그램을, 대조군에는 자가인지훈련을 1일 1회, 주 5회, 4주 동안 적용하고 그룹 간 비교를 실시하였다. 이때 중재의 효과를 검증하기 위하여 한국판 몬트리올 인지평가(Korean Montreal Cognitive Assessment; K-MoCA), 시계 그리기 검사(Executive Clock Drawing Test; ECDT), 선로잇기 검사(Trail Making Test; TMT), Rey-도형 검사(Rey Complex Figure Test; RCFT)를 사용하였다. 그 결과, 실험군은 K-MoCA, TMT, RCFT-delayed recall에서 유의하게 향상된 반면(p<.05), 대조군은 모든 평가에서 유의한 변화가 없었다. 또한, K-MoCA, TMT, RCFT-delayed recall에서 실험군과 대조군의 변화량이 서로 유의한 차이가 있음을 확인하였다(p<.05). 본 연구는 한국형 전산화 인지재활프로그램이 외상성 뇌손상 환자의 전두엽-집행기능을 향상시키기 위해 국내 임상 환경에서 사용하기에 적절한 중재 도구임을 지지한다.

• 생물정신의학
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• 제8권2호
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• pp.258-265
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• 2001

Objectives : Chronic alcohol consumption has been known to result in various neurocognitive deficits. Many neuropsychological studies revealed that the major disturbances occurred in the executive function, learning and short-term memory, visuospatial performance function, perceptuo-motor skills, and abstraction and problem solving abilities. This study was done to identify which cognitive areas might be mainly affected. Methods : The cognitive disturbance was evaluated using the Korean Version of the Mini Mental State Examination(MMSEK) and the 7 Minute Screen(7MS) in male inpatients with alcohol dependence(N=3 : as well as in age and education level matched healthy male controls(N=30). Four individual tests of the 7MS were consisted of the Benton Temporal Orientation Test, the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. Results : 1) The average scores of four individual test of the 7MS for the alcoholics were $2.77{\pm}4.38$ for the Benton Temporal Orientation Test, $13.90{\pm}2.02$ for the Memory Test(the Cued Recall $6.77{\pm}1.94$, the Uncued Recall $7.10{\pm}2.45$), $5.84{\pm}1.86$ for the Clock Drawing, and $12.58{\pm}3.29$ for the Category Fluency. Except the Benton Temporal Orientation Test, there were statistically significant differences between test scores of alcoholics and those of controls(p<0.01). 2) The alcoholics who had MMSE-K score <24 were 9.68%. The average(${\pm}S.D.$) score of the MMSE-K for the patient group($27.23{\pm}2.62$) was significantly(p<0.001) lower than that of the healthy controls($29.20{\pm}1.24$). There were no statistically significant differences between four individual test scores of the 7MS of alcoholics with the MMSE-K score <24(N=3) and those of alcoholics with the MMSE-K score ${\geq}24$(N=28). 3) Four individual test scores of the 7MS seemed to have statistically significant association with such variables as MMSE-K, duration of alcohol drinking, blood magnesium concentration, liver function and thyroid function. Conclusion : Mild deficits of cognitive areas such as orientation, memory, visuospatial abilities and verbal fluency could be found in alcohol dependence.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.191-198
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• 2010

Objective : This study is planned to determine the neurocognitive difficulties of hydrocephalic adults. Methods : The research group contained healthy adults (control group, n : 15), and hydrocephalic adults (n : 15). Hydrocephalic group consisted of patients with idiopathic aquaduct stenosis and post-meningitis hydrocephalus. All patients were followed with shunted hydrocephalus and not gone to shunt revision during last two years. They were chosen from either asymptomatic or had only minor symptoms without motor and sensorineural deficit. A neuropsychological test battery (Raven Standart Progressive Matrices, Bender-Gestalt Test, Cancellation Test, Clock Drawing Test, Facial Recognition Test, Line Orientation Test, Serial Digit Learning Test, Stroop Color Word Interference Test-TBAG Form, Verbal Fluency Test, Verbal Fluency Test, Visual-Aural Digit Span Test-B) was applied to all groups. Results : Neuropsychological assessment of hydrocephalic patients demonstrated that they had poor performance on visual, semantic and working memory, visuoconstructive and frontal functions, reading, attention, motor coordination and executive function of parietal lobe which related with complex and perseverative behaviour. Eventually, these patients had significant impairment on the neurocognitive functions of their frontal, parietal and temporal lobes. On the other hand, the statistical analyses performed on demographic data showed that the aetiology of the hydrocephalus, age, sex and localization of the shunt (frontal or posterior parietal) did not affect the test results. Conclusion : This prospective study showed that adult patients with hydrocephalus have serious neuropsychological problems which might be directly caused by the hydrocephalus; and these problems may cause serious adaptive difficulties in their social, cultural, behavioral and academic life.

• 혜화의학회지
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• 제15권1호
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• pp.1-9
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• 2006

For this study, we carried out dementia assessment examination of 74 patients with memory disturbance who have come to Cheongju oriental hospital of Daejeon university from April 2005 to February 2006. This study classified the patients as none-dementia(ND), questionable dementia(QD), and dementia(DA) groups and analyzed the result of examination. As a result, the following conclusion was drawn. 1. Among the 3 groups, there was no significant differences in the sex distribution. But according to age distribution, the age of QD and DA groups showed significant difference from that of ND group. 2. MMSE-K and HDS-K scores showed the significant differences among all groups, and 7 MS result showed the significant difference between ND and the other groups. 3. The DA group significantly got lower scores than ND group in the items of the MMSE-K, Orientation, Registration, Recall, Attention, Copy two pentagons and Comprehension. Especially, significant difference also was shown in the orientation item between QD and DA groups. 4. The scores in the items of 7 MS, Benton temporal orientation, Enhanced cued recall and Clock drawing showed significant difference among all groups. Category fluency score showed significant difference between ND and the other groups. 5. The results of Brain CT and clinical chemistry test didn't show significant difference among all groups.

• 대한한방내과학회지
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• 제37권2호
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• pp.156-165
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• 2016

Objectives: This study reports on two cases of the clinical application of traditional Korean medicine on stroke patients with hemi-spatial neglect.Methods: We applied several traditional Korean medicine treatments and then evaluated the patients’ symptoms with Albert’s test, the clock-drawing test (CDT), the Catherine Bergego scale (CBS), and the numeric rating scale (NRS).Results: The scores of all of the scales showed improvement. In case 1, the Albert’s test score decreased from 2.5% to 0%, the CDT score increased from 6 to 10, and the CBS score decreased from 16 to 11. In case 2, the Albert’s test score decreased from 5% to 2.5%, the CDT score increased from 3 to 6, and the CBS score decreased from 23 to 16.Conclusion: We found that acupuncture, moxibustion, herbal medicine, and physical therapy appeared to be effective treatments for hemi-spatial neglect in these two stroke patients.

• 한국컴퓨터정보학회논문지
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• 제26권11호
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• pp.191-199
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• 2021

본 연구는 노인운전자의 운전 면허를 갱신 할 때 필요한 추가 검사를 제안할 목적으로 실시되었다. 우리나라에서는 고령 인구가 빠르게 증가하면서 고령 운전자의 비율이 높아지고 있다. 전반적으로 교통사고율이 감소하고 있지만, 고령 운전자에서는 교통사고율과 교통사고로 인한 사망률이 증가하고 있다. 본 연구에서는 우리나라에서 실시하고 있는 고령 운전자의 운전면허 갱신 시 실시하고 있는 검사와 교육을 알아보고 외국의 현황과 비교하여 필요한 검사를 알아보기 위해 시행했다. 운전능력과 관련된 신체기능은 크게 시각, 인지, 운동 및 체성감각의 세 영역에 대해 평가하는 것이 적절하지만, 현재 우리나라에서는 시각 중 시력만을 평가하고 있고, 인지 영역에서는 경증 인지 손상은 알아볼 수 없는 MMSE-K와 시계 그리기 검사만을 진행하고 있다. 운전을 수행하는 운동능력에 대해서는 전혀 평가하고 있지 않다. 따라서 고령 운전자의 안전운전을 위해서는 운전면허 갱신 시 실시하는 검사에 시각에서는 시야와 대조대비력 검사, 인지 기능에서는 경증 인지장애를 구별할 수 있는 검사, 운동기능을 평가하기 위한 검사를 보완해야 할 것이다.

• 대한통합의학회지
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• 제8권2호
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• pp.89-95
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• 2020

Purpose : This study aims to evaluate the correlation of cognitive function, activities of daily living (ADL), and driving performance in stroke hemiplegic patients residing in Korea. Methods : Subjects of the study were 18 stroke hemiplegic patients admitted to hospitals situated in Seoul. A clock drawing test (CDT), a modified Barthel index (MBI), and a virtual reality driving simulator (Eca faros-driving simulator) were used to examine their cognitive function, their ADL ability, and their driving skills, respectively. Results : Driving skills of stroke hemiplegic patients were shown to be associated with the CDT evaluation tool (r=-.777) (p<.001), but they were found to have any correlation with MBI (r=-.022) (p>.05). Additionally, an individual's CDT showed that the driving simulator evaluation result (pass/fail) could be discriminated with a sensitivity of 100.0 %, a specificity of 40.0 %, and an accuracy of 66.7 %. The result confirmed that the CDT is a useful evaluation tool for screening driving ability in people with stroke. But the MBI did not show any significant results (sensitivity of 62.5 %, specificity of 40.0 %, and predicted the results of the simulator with 50.0 % of accuracy) (p>.05). Conclusion : This study shows that cognitive function influences the driving performance in people with stroke. Driving skills of stroke hemiplegic patients are seen to be highly related to CDT. In the field of driving rehabilitation, these findings could be useful for evaluating driving skills relating to CDT. Furthermore, the study results will set a guideline for domestic occupational therapists to use the evaluation tool for assessing driving abilities in people with stroke.

• 수면정신생리
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• 제20권1호
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• pp.15-21
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• 2013

목 적: 하지불안증후군에서의 인지기능 저하는 흔히 동반되는 수면박탈, 불안, 우울 등에 의해 영향을 받는다. 본 연구의 목적은 투약 받지 않고 있는 한국 노인 인구에서 하지불안증후군과 인지기능 저하와의 관련성을 동반 증상의 영향을 배제하고 살펴보는 것이다. 방 법: 연구대상은 25명의 투약 받고 있지 않은 한국 노인 하지불안증후군 환자군과 나이, 성별, 교육연한에 따라 짝지은 50명의 대조군이다. 모든 연구대상에 대해 CERAD-K 신경심리평가, 중증인지감퇴평가 척도, 전두엽 기능 평가, 그리고 시계 그리기 검사(CLOX)를 포함한 광범위한 인지기능 평가를 시행하였다. 또한 수면의 질 평가를 위해 피츠버그 수면의 질 지수(Pittsburgh Sleep Quality Index, PSQI), 우울증의 평가를 위해 노인우울척도(Geriatric Depression Scale, GDS)를 사용하였다. 결 과: 환자군과 대조군 사이의 PSQI와 GDS 점수의 차이는 없었다. 구성 재인 검사에서 환자군이 대조군에 비해 더 낮은 점수를 보였으며(t=-2.384, p=0.02), 이를 제외한 모든 영역의 인지기능 평가에서 환자군과 대조군의 유의미한 차이는 관찰되지 않았다. 우울감이 있는 대상($GDS{\geq}10$)은 그렇지 않은 군에 비해 언어 유창성, 간이 정신상태 검사, 단어목록기억, 길 만들기 검사, 전두엽 기능 평가의 영역에서 유의한 인지기능 저하를 보였다. 수면의 질이 낮은 대상(PSQI>5)은 그렇지 않은 군에 비해 인지기능 평가의 전 영역에서 차이를 보이지 않았다. 결 론: 본 연구에서 하지불안증후군 환자군을 대조군과 비교한 결과 환자군은 불면과 우울의 영향을 배제하면 비교적 인지기능이 보존된 것으로 관찰되었다. 환자군에서 관찰되었던 시각 인지 영역의 저하는 하지불안증후군에서의 도파민 신경전달계의 장애와 연관하여 해석해 볼 수 있다.