• Journal of Korean Academy of Nursing
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• v.51 no.3
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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.

• The Journal of Korean Society for School & Community Health Education
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• v.22 no.3
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• pp.83-96
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• 2021

Background & objectives: Cognitive function decline is a main factor influencing the overall life of the elderly and places a burden of society. The aime of this study was to investigate the risk factors of cognitive function decline of elderly living alone and living with a spouse. Methods: This study used the Korean Longitudinal Study of Ageing from 2014 to 2018. 243 older adults who lived alone and 1,155 lived with a spouse with the Korean version of Mini Mental State Examination scores in normal range at the time of 2014 were included in the analysis. Logistic regression analysis was conducted to determine the difference of risk factors affecting cognitive function decline between in elderly living alone and elderly living with a spouse. Results: Cognitive function decline incidence rate of elderly living alone was 30.5% and the elderly living with a spouse showed 23.0%. According to the results of logistic regression analysis, the risk factors of cognitive function decline in the elderly living alone was age and residential area, while in the elderly living with a spouse were age, education level, social networks, and depression. Conclusions: The factors that affect the cognitive function decline of the elderly living alone and the elderly living with a spouse were different. Accordingly, other measures to prevent cognitive decline are necessary.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.159-165
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• 2022

Objective: This clinical study describes the effect of Korean medicine on a patient with Delayed Neuropsychiatric Sequelae after Carbon Monoxide Poisoning. Case presentation: A patient with the delayed neuropsychiatric effects of carbon monoxide exposure was treated with herbal medicine, acupuncture, moxibustion, and cupping. Clinical symptoms were measured with the Korean Mini Mental State Examination (K-MMSE), Functional Independence Measure (FIM), and the Modified Barthel Index (MBI). After 32 days of treatment, the patient's K-MMSE score increased from 11 to 21 points, the FIM score from 52 to 94 points, and the MBI score from 46 to 84 points. There were no side effects. Conclusion: According to this case study, Korean medicine may be considered an effective treatment for delayed neuropsychiatric sequelae, although more studies are needed to confirm its validity.

• Physical Therapy Korea
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• v.29 no.4
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• pp.255-261
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• 2022

Background: For the elderly, masticatory function is one of the most important oral functions and the masticatory ability is related to the wearing of dentures. Many older people wear dentures for their masticatory function, but a significant number of older people who use dentures have found that they feel uncomfortable when performing their daily activities, such as performing masticating functions or talking. Objects: The purpose of this study is to investigate how the forward head posture (FHP), respiratory function and thickness of masseter (MS), and sternocleidomastoid (SCM) are affected by the presence or absence of dentures in the elderly, and what kind of correlation there is between these variables. Methods: The study was conducted on 11 patients in the normal group and 13 in the denture group. The participant's cognitive ability was evaluated using Mini-Mental State Examination Korean (MMSE-K), and the FHP was evaluated by measuring the craniovertebral angle (CVA). The thickness of the MS and SCM muscles were measured using ultrasound, and respiration was measured with a spirometry. As for the statistical method, the correlation of each variable was investigated using Spearman's correlation coefficient. Results: In the normal group, there was a significant correlation between forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) (p < 0.001), and in the denture group, FVC and FEV1 (p < 0.001), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (p < 0.001), CVA and Lt. MS (p = 0.012). Conclusion: CVA and Lt. MS of the denture group have a high negative correlation, it is related that the thickness of MS may be thick when the elderly wearing dentures are FHP.

• Journal of People, Plants, and Environment
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• v.23 no.1
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• pp.35-46
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• 2020

The purpose of this study was to investigate the effects of the horticultural therapy program on patients with mild cognitive impairment and mild dementia depending on the frequency and duration of the interventions. We developed the same 15-session program to improve cognitive functions and life satisfaction and alleviate depression of the elderly women with mild cognitive impairment or mild dementia. Subjects in Longer Treatment group participated in the program once a week for 15 weeks and subjects in Shorter Tratmet group participated twice a week for 7½ weeks. This study conducted pretest-posttest verification of both groups using quasi-experimental design involving 21 subjects. Elderly life satisfaction, Geriatric Depression Scale (short form), and the Korean Version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) were used in the evaluation. As a result, both groups showed an increase in life satisfaction, and a decrease in depression. However, there was a significant difference in the changes of the CERAD-K scores between the two groups (p < .05). In Longer Treatment group, life satisfaction increased significantly (p < .001), and depression decreased at a marginally significant level (p = .068), but no statistically significant change was observed in neurocognitive function. In Shorter Treatment group, life satisfaction increased at a marginally significant level (p = .059), and depression and CERAD-K scores decreased significantly (p < .05). However, in the case of Mini-Mental State Examination (MMSE-K), there was no significant change in both groups. According to these results, when planning a horticultural therapy program for persons with mild cognitive impairment or mild dementia, it is effective to organize and execute the program by determining the duration of intervention as 3 to 4 months or longer, even if this reduces the number of interventions per week.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.51-58
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• 2022

PURPOSE: This study aimed to evaluate the correlation between executive function and gait evaluations for the elderly, and validate the obstacle gait evaluation as a cognitive impairment test tool. METHODS: This study was a cross-sectional design. 79 people aged 65 years or older were selected as subjects. The Korean version of the Mini-Mental State Examination (MMSE-KC) to evaluate overall cognitive function and the Trail Making Test (TMT) A, B to measure executive function were performed. The 4-meter walking speed test and the walking speed test while crossing over an obstacle were carried out to evaluate gait. The Spearman's correlation was used to measure the correlation between cognition and gait speed. RESULTS: There was no significant correlation between the 4 m gait speed and executive function( TMT-A (p = .056), TMT-B (p = .115)). However, there was a significant correlation between the 4 m gait speed and MMSE-KC (r = .277, p < .05). There was also a significant correlation between walking speed while crossing over an obstacle and all tests (MMSE-KC (r = .382, p < .01). TMT-A (r = -.327, p < .01), TMT-B (r = -.283, p < .05)). CONCLUSION: It was found that the gait speed while crossing over an obstacle was correlated with all cognitive function tests. Therefore, we suggest the use of the gait speed test while crossing over an obstacle rather than the simple gait test to diagnose cognitive decline.

• Nutrition Research and Practice
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• v.16 no.5
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• pp.673-684
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• 2022

BACKGROUND/OBJECTIVES: Although adherence to a higher diet quality may help prevent cognitive decline in older adults, literature for this in a Korean population is limited. Thus, the aim of this study was to examine the association between diet quality indices and the risk of mild cognitive impairment (MCI) in Korean older adults. SUBJECTS/METHODS: This cross-sectional study included 806 community-dwelling people aged 60 yrs and over in Korea. Diet quality was assessed via the revised Recommended Food Score (RFS) and alternate Mediterranean Diet Score (aMDS). Cognitive function was measured using a Korean version of the Mini-Mental State Examination (MMSE-KC). Associations between diet quality indices and MMSE-KC score were assessed with a general linear model after adjusting for covariates. Logistic regression was used to determine the association between diet quality indices and the risk of MCI. RESULTS: The prevalence of MCI was 35.3%. There were no significant trends between MMSE-KC scores and RFS and aMDS after adjusting for age, gender, education, exercise, living status, social activity, and alcohol drinking. Among total subjects, RFS was inversely associated with the risk of MCI after adjusting for covariates (Q5 vs. Q1; odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.83). Among total subjects and men, aMDS was inversely related to the risk of MCI after adjusting for covariates (Q5 vs. Q1; OR, 0.51; 95% CI, 0.29-0.89 for total subjects; Q5 vs. Q1; OR, 0.36; 95% CI, 0.15-0.83 for men). CONCLUSIONS: Our results demonstrate that high diet quality evaluated by RFS and aMDS is inversely associated with the risk of MCI. Thus, high quality diet may reduce or retard cognitive decline in the old population. Longitudinal studies are needed to determine the causal relationship between diet quality and the risk of MCI in the elderly.

• The Journal of Internal Korean Medicine
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• v.44 no.1
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• pp.66-76
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• 2023

Background: The aim of this study is to investigate the use of heart rate variability on a stroke patient with autonomic dysfunction and the effectiveness of Bunshimgi-eum. Case report: The patient showed autonomic dysfunction, including chest discomfort, 煩燥 (sweating, anxiety, insomnia, nausea, lightheadedness), and abdomen discomfort (dyspepsia, heartburn) after ischemic stroke. She was treated with a herbal medicine (Bunshimgi-eum) through complex Korean medicine treatment. The effect was evaluated using heart rate variability (HRV), Mini-Mental State Examination-DS (MMSE-DS), mean pulse rate, and subjective percentage of symptoms. After treatment, the HRV score, MMSE-DS score, and subjective percentage of symptoms improved, and the pulse rate decreased from the upper boundary value. Discussion: The results suggest that HRV may be useful in evaluating stroke patients with autonomic dysfunction and that Bunshimgi-eum is suitable for treatment.

• 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.