• Journal of Integrative Natural Science
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• v.11 no.3
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• pp.139-147
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• 2018

Hippocampal atrophy is a well-established imaging biomarker of Alzheimer disease (AD). However, hippocampus is a non-homogenous structure with cytoarchitecturally and functionally distinct sub-regions or subfield, with each region performing distinct functions. Certain regions of the subfield have shown selective vulnerability to AD. Here, we are interested in studying the effects of normal aging and mild cognitive impairment on these sub-regional volumes. With a reliable automated segmentation technique, we segmented these subregions of the hippocampus in 101 cognitively normal (CN), 135 early mild cognitive impairment (EMCI), 67 late mild cognitive impairment (LMCI) and 48 AD subjects. Thereby, dividing the hippocampus into hippocampal tail (tail), subiculum (SUB), cornu ammonis 1 (CA1), hippocampal fissure (fissure), presubiculum (PSUB), parasubiculum (ParaSUB), molecular layer (ML), granule cells/molecular layer/dentate gyrus (GCMLDG), cornu ammonis 3(CA3), cornu ammonis 4(CA4), fimbria and hippocampal-amygdala transition area (HATA). In this cross sectional study of 351 ADNI subjects, no differences in terms of age, gender, and years of education were observed among the groups. Though, the groups had statistically significant differences (p < 0.05 after the multiple comparison correction) in the Mini-Mental State Examination (MMSE) scores. There was asymmetrical volume loss in the early stages of AD with the left hemisphere showing volume loss in regions that were unaffected in the right hemisphere. Bilateral parasubiculum, right cornu ammonis 1, 3 and 4, right fimbria and right HATA regions did not show any volume loss till the late MCI stages. Our findings suggest that the hippocampal subfield regions are selectively vulnerable to AD and also that these vulnerabilities are asymmetrical especially during the early stages of AD.

• PNF and Movement
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• v.15 no.3
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• pp.361-371
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• 2017

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

• The Journal of Internal Korean Medicine
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• v.41 no.1
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• pp.97-110
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• 2020

The purpose of this case study was to report the effectiveness of aphasia in patients with cerebral infarction with hydrocephalus. A patient diagnosed with a middle cerebral artery infarction and hydrocephalus was treated with Gami-cheongeumjowi-tang, acupuncture, and moxibustion. The degree of improvement of symptoms was evaluated using the Korean version of the Frenchay Aphasia Screening Test (K-FAST) and the Mini-Mental State Examination-Korea (MMSE-K). At the time of admission, the K-FAST score was 7 points and the MMSE-K score was 4 points because no words other than 'Yes' could be spoken. At discharge, the K-FAST score was 22 points and the MMSE-K score was 19 points. A particularly noticeable improvement was found in spoken and written comprehension, reading, and repetition. The study findings indicate that Korean medicine treatment can be used to treat the symptoms of patients with aphasia. The periventricular region may be distorted by hydrocephalus, resulting in Broca's aphasia in a cerebral infarction of the middle cerebral artery inferior division.

• Research in Community and Public Health Nursing
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• v.19 no.1
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• pp.36-45
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• 2008

Purpose: This study was to estimate the prevalence of dementia in order to estimate the associations of dementia with its risk factors in the community elderly. Methods: The multistage random cluster sampling method was used to select the subjects. The response rate was 94.3%. For the 1st stage screening survey, the Korean-version Mini-Mental State Examination (K-MMSE) and the Bathel Index of activities of daily living (ADL) and instrumental activities of daily living (IADL) were used as primary screening tools. At the 2nd stage. diagnoses were confirmed according to the Clinical Dementia Rating Scale (CBR) and Computer Tomogram (CT). Results: Age-sex adjusted prevalence (%) [95% CI] of dementia was 6.25% [4.47-7.83] (male 4.21% [2.40-6.02]; female 8.28% [5.71-10.85]). Four statistically significant risk factors of the dementia were identified: age 70-74 (OR=1.367), age 75-79 (OR=1.712), age 80-84 (OR=2.465), age 85 over (OR=7.363) illiteracy (OR=3.827); unconsciousness after head injury (OR=3.383), and no exercise (OR=2.188). Hosmer and Lemeshow goodness-of-fit index of dementia risk model was E (legit of dementia)= -4.337+$0.312^*Age(70{\sim}74)+0.538^*Age(75{\sim}79)+0.902^*Age(80{\sim}84)+1.996^*Age$(85over)+$1.342^*$Illiteracy+$1.219^*$Unconsciousness after head trauma+$0.783^*$No exercise. We confirmed that the overall prevalence of dementia in adults aged 65 and older was 94.3%. The risk factors of dementia were explained by age, illiteracy unconsciousness after head trauma and no exercise. Conclusion: These data have been used to estimate the incidence of dementia in elderly community population and to manage the possible role of risk factors as predictors of dementia.

• Journal of Korean Public Health Nursing
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• v.17 no.1
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• pp.69-82
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• 2003

Purpose: The purpose of this research was to evaluate the effect of horticultural therapy on cognitive function, self-esteem, depression and activities of daily living of elderly with dementia. Method: The research design was an one group pre and post-test study design. The subjects of this study were 7 elderly with dementia in K elderly institution in Daegu. Instruments used in this research were MMSE-K(Mini-mental state Examination Korean Version) developed by Kwon & Park, SES(Self-Esteem Scale) developed by Rosenberg. SDS(Self-Rating Depression Scale) developed by Zung and BADL(Bathel Activity Daily Living) developed by Bethel. One-hour horticultural therapy was offered to the study participants weekly for 12 weeks. Results: The results showed that self-esteem was significantly increased after the horticultural therapy. However, in terms of cognitive function. depression and ADL, there was no significant change after the horticultural therapy among these elderly. Conclusion: In this research. there were no obvious change in cognitive function. depression, and ADL after the horticultural therapy among participants. Although the difference was not statistically significant. descriptive statistics showed some difference in scores on these variables after the intervention. So, it is suggested to conduct a further research with larger samples and pre and post-test design with control group.

• 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.

• Korean Journal of Adult Nursing
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• v.28 no.4
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• pp.367-377
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• 2016

Purpose: The purpose of this study was to explore the quality of life (QoL) in patients with Alzheimer's disease (AD) and their and caregivers and its influencing factors. Methods: A descriptive research design was used. 211 pairs of AD patients and their caregivers were recruited from a neurology outpatient clinic of S medical center in Seoul, Korea. Caregivers completed several structured questionnaires regarding AD patients' QoL as well as their QoL, patients' behavioral and psychological symptoms, patients' activities of daily living (ADL), social support, and quality of relationship between AD patients and caregivers. Cognitive status of AD patients was assessed by the researchers using Korean Mini-Mental State Examination. Results: The scores of QoL were 26.91 for AD patients and 85.62 for their caregivers. In the multiple regression, factors associated with AD patients' QoL were the quality of relationship (${\beta}$=.44), ADL (${\beta}$=-.33), patient's age (${\beta}$=.20), caregivers' QoL (${\beta}$=.20), and patient's gender (${\beta}$=.11). Factors associated with caregivers' QoL were the quality of relationship (${\beta}$=.34), relationship (${\beta}$=.32), patient's QoL (${\beta}$=.26), caregivers' gender (${\beta}$=.18), social support (${\beta}$=.12), and the level of caregivers' education (${\beta}$=.12). Conclusion: To improve the QoL in AD patients and their caregivers, strategies to promote their quality of relationship are needed.

• Korean Journal of Adult Nursing
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• v.28 no.2
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• pp.202-212
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• 2016

Purpose: The purpose of this study was to assess the relationship between cognitive function impairment and quality of life (QoL) among patients with breast cancer. Specifically, the intention was to verify the mediating effects for promoting behaviors leading to better health and QoL. Methods: A purposive sample of 152 patients undergoing chemotherapy was recruited. A cross-sectional survey design was used. Data were collected using four instruments: Everyday Cognition Scale, Korean Mini-Mental State Examination, Functional Assessment of Cancer Therapy-Breast Cancer Version 4, and Health Promoting Lifestyle Profile. Results: The mean score for subjective cognitive decline was 65.84; the health promotion behavior was 95.89, and 83.34 for QoL. Health promotion behavior was directly affected by cognitive decline ($R^2=6.0%$) as was QoL ($R^2=43%$). Subjective cognitive decline (${\beta}=-.57$ p<.001) and health promotion behavior (${\beta}=.37$, p<.001) were seen as predicting factors in QoL and explained 56% ($R^2=56%$). Health promotion behavior had a partial mediating effect in the relationship between self-reported cognitive decline and QoL (Sobel test: Z=-3.37, p<.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline and promoting health promotion behavior are highly recommended to improve QoL in cancer patients.

• Journal of Korean Academy of Nursing
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• v.37 no.7
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• pp.1049-1060
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• 2007

Purpose: This study was conducted to investigate the effects of a cognitive behavior program on cognition, depression, and activities of daily living in elderly with Cognitive Impairment. Method: The research design was a nonequivalent control group pretest-posttest design. There were 21 subjects in the experimental group and 19 in the control group among 40 senior residents in a Hall for the elderly in the city of S. The subjects scores ranged from 15 to 23 on the MMSE-K(Korean Version of Mini-Mental State Examination) over age 65. The length of time for data collection and intervention was from Jun 26 to September 1, 2006. The cognitive behavior program consisted of 'Facing problem behavior', 'Searching for a coping skill', and 'Training in the coping skill'. It was applied to the experimental group twice a week, fifty minutes per session for six weeks. Result: Cognition(t=-4.232, p< .001) and IADL(t=-2.939, p< .01) in the experimental group were significantly higher than those of the control group. Depression in the experimental group was significantly less than the control group(t=3.870, p< .01). However, ADL in the experimental group was not significantly higher than the control group. Conclusion: These findings confirmed that a cognitive behavior program contributed to improving cognition and IADL, and to reducing depression in the elderly with Cognitive Impairment.

• 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.