• Journal of Oriental Neuropsychiatry
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• v.30 no.2
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• pp.47-58
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• 2019

Objectives: To conduct and report the results of a public health promotion program in Korean medicine (KM), namely the KM Visiting Care Service for Solitary Elderly, from November 2018 to April 2019. Methods: Six elderly people living in a rural area received the KM visiting care service, twice a week, for four months. This service consisted of acupuncture, auriculotherapy, and supportive counseling to manage their musculoskeletal pain, cognitive impairment, and/or depression. The changes of symptoms were assessed using Numeric Rating Scale (NRS), Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Korean version of Montreal Cognitive Assessment (MoCA-K), and Geriatric Depression Scale-Short form Korean (GDS-SF-K). Results: Through the 4-months KM visiting care service, the overall subjects' NRS-rated pain decreased slightly. Most showed improvement in MMSE-DS and/or MoCA-K, except one subject who was diagnosed with Alzheimer's disease. Depression assessed by GDS-SF-K showed improvement in a few subjects who were unable to walk independently. Satisfaction assessed through survey was generally high in all subjects. Conclusions: This KM Visiting Care Service for Solitary Elderly may help improve the pain and cognitive function of frail solitary elderly in rural areas. However, the protocol need to be improved to optimize the effect.

• Journal of the Korean Society of Food Culture
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• v.7 no.2
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• pp.149-155
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• 1992

This study was carried out to find out the effect of dietary intake on cognitive function retardation in old age using dietary survey and cognitive function test. The subjects were 332 men of 50-94 years old and their activities of daily living were very similar. The cognitive function was tested by Mini Mental State Examination (MMSE)-K which was translated from MMSE, and the 24-hour recall method was used for dietary survey. Scoring of MMSE-K was a little different from MMSE, that is, in case of no education, one to four points were added to exclude the effect of education which has been considered as a confounder by many researchers. The number of subjects belonging to below 23 of MMSE-K score was increased by increasing age. Even though points were added in case of no education, the ratio of below 23 MMSE-K score group was diminished by increasing education. Therefore, education seems not to be a confounder but a independent variable on cognitive function. Income, past occupation, family type, self-evaluated health status did not play any effect on cognitive function significantly. On the other hand, the correlation between each nutrients and the score of cognitive function test showed that the more consumption of vitamin A and protein, the higher cognitive function score was obtained. In case of iron and Ca, even though it was not statistically significant, there was a tendency of increasing cognitive function score by increasing the intake of those nutrients. This study suggests that micronutrient intakes might be more related to cognitive function than macronutrients.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.1
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• pp.23-30
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• 2014

Objectives : Homocysteine has been associated with cognitive impairment and various psychiatric symptoms. This study was designed to examine the relationship exists between plasma homocysteine concentration and behavioral and psychological symptoms of dementia(BPSD). Methods : 41 subjects with dementia of Alzheimer's type were included in this study. We carried out history taking, physical examination, and cognitive assessment for the diagnosis of dementia of Alzheimer's type based on DSM-IV. We scored the Mini Mental State Examination(MMSE), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), and the Korean Neuropsychiatric Inventory(K-NPI). We also measured levels of homocysteine, folate, and vitamin $B_{12}$ in the plasma. Results : We found statistically significant positive correlations between homocysteine concentration with NPI total score, and with scores of several sub-domains such as delusion, agitation/aggression, depression/dysphoria, and elation/euphoria. No significant correlation existed between homocysteine levels and scores of MMSE, GDS, and CDR. Conclusions : This study shows that plasma homocysteine levels are associated with BPSD. Further research is necessary to identify pathophysiologic mechanisms underlying these relationships.

• 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.

• Korean Journal of Health Education and Promotion
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• v.33 no.1
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• pp.23-32
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• 2016

Objectives: The aim of this study was to examine the effects of home-based cognitive physico-occupational therapy(HBCPOT) on cognitive function, depression, and quality of life in dementia patients, using a cognitive impairment model. Methods: The data was analysed for Mini-Mental State Examination-Korean version (MMSE-KC) for assessing cognitive function, Quality of life-Alzheimer's Disease (QOL-AD) and Geriatric Depression Scale (GDS) in 31 dementia patients who received home-based cognitive physico-occupational therapy for one hour once a week for 12 weeks by a trained occupational therapist at the Dementia Prevention and Management Center of Y-city during 20111-2013. Results: Among these 31 patients, 18(58.1%) were female, and 25(80.6%) had Alzheimer's Disease. After HBCPOT, the mean scores of MMSE-KC and QOL-AD were significantly improved, but GDS score was not significantly decreased. Conclusions: It was suggested that HBCPOT was effective in improving cognitive function and quality of life.

• Physical Therapy Korea
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• v.13 no.2
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• pp.26-34
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• 2006

The aim of this study was to assess the effectiveness of group therapeutic exercise programs on the cognitive function, Activities of Daily Living (ADL), and balance-performing ability in older adults. Fifteen community-dwelling subjects (mean age 73.7 yrs, standard deviation 2.4) participated in this study. An 8-week group therapeutic exercise program, including strengthening and balance training, breathing and gait exercise, and recreation, consisted of activities related to daily living. The Mini-Mental State Examination-Korean (MMSE-K), Modified Barthel Index (MBI), Berg Balance Scale (BBS), Functional Reaching Test (FRT), and Timed Up & Go (TUG) test were measured during pre-exercise and post-exercise points. The results of this study were as follows: 1. After eight weeks, the MMSE-K and MBI total score was more significantly increased for post-exercise tests than pre-exercise tests (respectively, p<.05, p<.01). 2. Of the MBI contents, personal hygiene, dressing, ambulation, and chair/bed transfers scores were significant increased for post-exercise tests. 3. Post exercise BBS, FRT, and TUG scores were higher than the pre-exercise scores. The difference was statistically significant (respectively, p<.05, p<.05, p<.01). These findings suggest that group therapeutic exercise can be used to improve the cognitive function, ADL, and balance-performing ability in elderly persons.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.28-33
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• 2014

Objective : Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. Methods : Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. Results : Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were $19.1{\pm}5.4$, $0.9{\pm}0.6$, and $3.3{\pm}1.1$. These were significantly lower than those of Group B ($25.6{\pm}3.4$, $0.5{\pm}0.2$, and $2.1{\pm}0.7$) (p<0.05). BIS was lower in Group A ($30.2{\pm}6.8$ compared to $35.4{\pm}5.6$ in group B) (p<0.05). The number of BIS <40 were $5.1{\pm}3.1$ times in Group A, $2.5{\pm}2.2$ times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. Conclusion : Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.71-78
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• 2014

Objectives : Behavioral and psychological symptoms of dementia(BPSD) represent significant clinical problems, resulting in functional decline, caregiver distress, institutionalization and increased mortality. A recent study showed gender differences have important role in the development of BPSD, but relationship between BPSD and gender has never been studied in Korea. This study was designed to examine whether patients with Alzheimer's disease show gender differences in behavioral and psychological symptoms of dementia(BPSD). Methods : Ninety-eight subjects with Alzheimer's disease were included in this study. We carried out history taking and cognitive assessment for the diagnosis of Alzheimer's disease based on DSM-IV. Cognitive impairment and BPSD were measured using the Mini Mental State Examination(MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating(CDR) and the Korean Neuropsychiatric Inventory(K-NPI). Independent samples t-test was used to examine the differences across gender in BPSD. Correlation analysis between MMSE, CDR, GDS and NPI was performed using Pearson's correlation coefficient. Results : There were no significant gender differences between the gender in BPSD. We found statistically significant negative correlations between MMSE with NPI total score, and with scores of several sub-domains such as hallucination. Conclusions : This study showed that gender differences in BPSD are not significant. Further research is necessary to identify whether BPSD affect gender differences or individual differences.

• 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.