Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.
Journal of The Korean Society of Integrative Medicine
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v.9
no.3
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pp.37-45
/
2021
Purpose : This study aimed to present normative data and cut-off points for older Korean adults completing the Montreal Cognitive Assessment - Korean (MoCA-K), which is used as a screening test for mild cognitive impairment in Korea. Methods : A total of 195 healthy adults ≥60 years were recruited. All participants completed the MoCA-K and the Korean - Mini-Mental State Examination (MMSE-K) to assess their cognitive function. Participants were divided into six groups based on their age: 60-64 years, 65~69 years, 70~74 years, 75~79 years, 80~84 years, and 85~89 years. Results : The results revealed that MoCA-K score decreased significantly with age (mean score ± standard deviation [SD]; 27.63±2.80 in subjects aged 60~64 years; 27.00±2.39 in subjects aged 65~69 years; 24.94±2.96 in subjects aged 70~74 years; 24.74±3.37 in subjects aged 75~79 years; 22.59±4.72 in subjects aged 80~84 years; and 18.83±5.38 in subjects aged 85~89 years; p<.001). Additionally, MoCA-K score also increased significantly with educational level (mean score±standard deviation [SD]; 19.95±4.78 in no formal education group; 24.95±2.22 in elementary school graduated group; 26.35±2.72 in middle school graduated group; 28.32±1.36 in high school graduated group; and 28.50±1.51 in more than college graduated group; p<.001). The optimal cut-off points were 24/25 for 60~69 years old group, 21/22 for 70~79 years old group, 17/18 for 80~84 years old group, and 13/14 for 85~89 years old group. The optimal cut-off points were 15/16 for individuals who were illiterate, 22/23 for individuals with 6 years of education, 22/24 for individuals with 9 years of education, and 26/27 for individuals with 12 or more years of education. Conclusions : This study presents normative data and cut-off points for the MoCA-K in older Korean adults. This data will facilitate more accurate detection and follow-up of the risk of mild cognitive impairment in this population, taking into consideration age and education. Future studies are required that should focus on the cut-off score on the level of education according to age.
Kim, Seungyeon;Shin, Sangyoon;Yoo, Hyejin;Park, Gi Hyue;Lee, Jee-Young;Lee, Jeong Sang;Lee, Euni
Korean Journal of Clinical Pharmacy
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v.29
no.4
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pp.238-246
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2019
Background: In South Korea, as an aged society, an understanding of dementia and its risk factors is important from clinical and healthcare policy perspectives. Relationship between cognitive impairment and body weight or weight changes have been reported, but these were contradictory. We have evaluated the association between weight changes and cognitive decline using national level longitudinal data. Methods: Data from the Korean Longitudinal Study of Ageing from 2006 to 2012 were used. Association between weight changes and decline in cognitive function as measured by K-MMSE (the Korean version of the Mini-mental state examination) score was assessed by multivariate logistic regression. Weight changes were calculated from 1st wave and 3rd wave survey data, and classified into five groups as stable, increases, decreases of >10%, or 5%-10%. Results: About 37% of the total participants (n=4,512) were 65 years or older. These participants made up the largest proportion of the groups with weight change exceeding 10%. Multivariate logistic regression analyses revealed that weight changes exceeding 10% (10% increase vs stable, adjusted OR [aOR] 1.47, 95% confidence interval (CI) 1.11-1.95; 10% decrease vs stable, aOR 1.44, 95% CI 1.11-1.88) were significant predictive factors for decline in cognitive function. In subgroup analyses, the association between weight changes and cognitive decline was significant in males aged over 65 years and in normal BMI groups. Conclusion: Weight changes, both increases and decreases exceeding 10% of baseline, were significantly associated with declines in cognitive function among older adults in South Korea.
The Journal of Korean society of community based occupational therapy
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v.2
no.1
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pp.49-63
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2012
Objective : The purpose of study was to verify the clinical effect of a Korean Computer-based cognitive rehabilitation program(called CoTras) for recovering the visual perception function and ADL in stroke. Methods : A CBCRT was applied to 14 Stoke patients who rehabilitation professional medical treatment hospital. All participant were evaluated with four standardized assessment tolls(Motor-Free Visual Perception Test; MVPT, Korean version of Mini-Mental State Examination; MMSE-K, Assesment of Motor and Process Skills: AMPS) before and after the planned computer based cognitive rehabilitation sessions. Results : A significant effect was confirmed (p<.05) from the CBCRT which visual perception function. By each entry comparative result, visual memory, figure ground, visual close, spatial relation, visual discrimination, were the order of treatment. Neither was found any significant effect in improving process skills from AMPS. Conclusion : These results indicate that CoTras have effects on improving visual perception and ADL performance in stroke patients. Will be able to present with the fundamental data CoTras will be able to contribute to increase visual perception function & ADL performance to the stroke patient who has visual perception dysfunction.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.10
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pp.7078-7088
/
2015
This study examined effects of health behaviors and sleep related factor on cognitive function in the elderly hypertensive patients. Data were collected through a face to face interview survey with structured questionnaire form 140 elderly with hypertension ($age{\geq}65years$) from February 5 to May 1, 2013. Research instruments included Pittsburgh Sleep Quality Index(PSQI), Epworth Sleepiness Scale(ESS) and Korean version the Mini-Mental State Examination(MMSE-K). Cognitive function was negatively related to degradation in quality of sleep(r=-.29, p<.001). Sleep duration were negatively related to body mass index(r=-.18, p=.032) and degradation in quality of sleep(r=-.59, p<.001). Sleep duration was positively related to daytime sleepiness(r=.22, p=.008). Hierarchical multiple regression showed that age, education levels and living arrangement were associated with cognitive function(F=8.56, p<.001, Adjusted $R^2=.14$). After controlling for demographic characteristics and health behaviors, degradation in quality of sleep(${\beta}=-.27$, p=.008) was identified as significant predictors of cognitive function. This final model explained 17.0% of the cognitive function in the elderly hypertensive patients(F=4.09, p<.001). Therefore, as a strategy improving cognitive function of the elderly with hypertension, therapeutic intervention should be developed to improve quality of sleep considering age, education levels and living arrangement.
Objectives: The aim of this study was to investigate the association between masticatory ability, oral health-related quality of life, and cognitive function in an elderly population using structural equation modeling. Methods: A total of 308 subjects, aged 65 years and over, were recruited from the senior citizen center in Daegu, South Korea and provided consent for inclusion in the study. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to assess the level of cognitive function. Masticatory ability was evaluated through chewing tests, patient-perceived masticatory function and, measurement of relative occlusal forces on molar teeth using the T-Scan $III^{(R)}$ system. All data were analyzed using ${\chi}^2$ tests, t-tests, and one-way ANOVA in SPSS version 23.0 for windows. Structural equation modeling was performed using SPSS AMOS version 22.0. Results: There was a significant association between cognitive function and molar teeth occlusal force. Ability of food chewing score and patient-perceived masticatory function could affect oral health-related quality of life (P>0.05). Higher occlusal forces on molar teeth, compared to anterior teeth, positively correlated with higher cognitive function. Conclusions: These results suggest that an individual's oral health condition could affect molar teeth occlusal forces and may be related to a risk of developing dementia. Therefore, there is a need for implementing nation-wide policies to improve oral health, such as masticatory function, in the elderly population.
Kim, Hye-Young;Lee, Jung-Sug;Youn, Jong-Chul;Chang, Moon-Jeong
Journal of Nutrition and Health
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v.49
no.5
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pp.313-322
/
2016
Purpose: This study was conducted to examine the relationship among cognitive function, nutrition screening initiative (NSI) score, and food intake status. Methods: A total of 409 subjects aged over 60 years were recruited from the Yongin dementia prevention and control center. Mini Mental State Examination Dementia Screening (MMSE-DS) method was used to assess the cognitive function of the subjects. Information on health related behaviors and food intake was collected by face to face interview using a structured questionnaire. The questionnaires included the NSI DETERMINE checklist, food intake sheets by 24 hr recall method and by semi-quantified food frequency questionnaire. Results: Subjects were divided into low cognitive or normal groups according to the MMSE-DS result. The prevalence of low cognitive function in the subjects was 25.7%. The low cognitive group exercised less and had higher nutritional health risk than the normal group. The low cognitive group had lower consumption of polyunsaturated fatty acid and higher tendency of thiamin, riboflavin, and iron deficiency. The low cognitive group had less frequency of eating mackerel, pepper, tangerine, and watermelon and higher frequency of eating white rice and cookies than the normal group. Conclusion: The results of this study imply that the cognitive function of elderly is related to exercise behavior, nutritional health risk, and food and nutrient intake status.
This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.
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