• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.10
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• pp.7078-7088
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• 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.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.628-640
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• 2017

Purpose: To describe the effectiveness of traditional Korean medicine (TKM) on the patients with secondary dementia (case 1: Rt. MCA infarction; case 2: traumatic subacute subdural hemorrhage and traumatic intracranial hemorrhage; case 3: delayed encephalopathy after carbon monoxide poisoning). Methods: We used a complete TKM treatment. The acupoints used were as follows: acupoints frequently used in hemiparesis (GV20, GV24, ST4, LI11, LI14, ST36, GB34, SP9, and LR3), and we used herbal medicine (補腎益腦湯加味, Boshiniknoe-tang-gami). The efficacy was evaluated using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Modified Barthel Index (MBI). Results: After treatment, the total MMSE-DS score was increased from 14 to 24 (case 1), 14 to 19 (case 2), and 0 to 17 (case 3). The total K-MBI was increased from 30 to 44 (case 1), 82 to 86 (case 2), and 30 to 86 (case 3) Conclusions: We suggest that TKM could positively influence cognition and improve activity of daily living (ADL). This study has limitations, so further studies are needed.

• 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.

• Journal of Digital Convergence
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• v.15 no.4
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• pp.469-476
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• 2017

Mini-Mental State Examination (MMSE) and naming tests have been used clinically as screening and diagnostic tools for mild cognitive impairment and dementia. Researches in other countries have reported that residential areas would affect one's cognitive abilities. In Korean, however, there was no systematic studies on geographical influences to cognitive ability among a sample of urban/rural residents. The aim of this study was to investigate the effect of urban/rural locality of residence on cognitive tests in normal elderly Korean. Residents aged 65 years and older (N=108) were administered the K-MMSE, confrontation/generative naming tests, and medical/socio-demographic interview. When comparing the total number of correct responses between urban residents and rural residents, the performances of rural group were significantly worse than those of the urban group in K-MMSE. Based on the results, our finding suggests that a factor of residential locality should be considered to examine the function and explain the cognitive decline in rural community-dwelling elders.

• Nutrition Research and Practice
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• v.12 no.2
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• pp.160-165
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• 2018

BACKGROUND/OBJECTIVES: Korea is quickly becoming an aged society. Dementia is also becoming a vital public health problem in Korea. Cognitive impairment as a pre-stage of dementia shares most risk factors for dementia. The aim of the present study was to determine associations of serum levels of vitamins A, C, and E with the risk of cognitive impairment among elderly Koreans. SUBJECTS/METHODS: In this cross-sectional study, a total of 230 participants aged 60-79 years from Yangpyeong cohort were included. Cognitive function was assessed by the Korean version of the Mini-Mental State Examination for Dementia Screening. The logistic multivariable regression model was applied to determine the effect of serum vitamins A, C, and E on the risk of cognitive impairment. RESULTS: There was no significant association between the risk of cognitive impairment and serum levels of vitamin A and vitamin C. There was a significant odd ratio when the second tertile group of beta-gamma tocopherol level was compared to the first tertile group [odds ratio (OR) = 0.37, 95% confidence interval (CI) = 0.14-0.98, P for trend = 0.051]. In subgroup analyses, there were significant negative associations between beta-gamma tocopherol level and the risk of cognitive impairment in men (OR = 0.17, 95% CI = 0.03-0.87, P for trend = 0.028), non-drinkers or former drinkers (OR = 0.13, 95% CI = 0.02-0.66, P for trend = 0.025), and non-smokers or former smokers (OR = 0.27, 95% CI = 0.09-0.82, P for trend = 0.017). CONCLUSION: Serum beta-gamma tocopherol levels tended to be inversely associated with the risk of cognitive impairment. Further prospective large-scaled studies are needed to examine this association.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.94-101
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• 2016

Objectives : Anemia is a common problem in the management of elderly patients. Recent studies reported that anemia was associated with cognitive impairment and Alzheimer's disease. This study was aimed to analyze the differences of hemoglobin levels in Korean patients with Alzheimer's disease(AD) dementia, mild cognitive impairment(MCI), and healthy controls. Furthermore, the study also examined if any association between hemoglobin levels and cognitive functions existed. Methods : A total of 116 Korean elderly adults were participated in this study(mean age 74.67 years ; 60.3% female). The Korean version of the Mini-Mental State Examination(MMSE-K), Clinical Dementia Rating(CDR) and Global Deterioration Scale(GDS) were applied to all subjects. Hematological and related blood chemistry values were investigated. Results : We found that patients with AD dementia had significantly lower hemoglobin and hematocrit levels than MCI subjects and healthy control group. The hemoglobin levels showed a positive correlation with MMSE-K and negative correlation with CDR, GDS. Conclusions : Among Korean elderly, low hemoglobin level is associated with a cognitive impairment. This study indicates that AD is associated with anemia, and low hemoglobin levels may contribute to potentially useful clinical markers of AD. The risk factor for dementia needs to be confirmed by prospective longitudinal studies in a larger group of patients.

• 재활복지
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• v.20 no.4
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• pp.265-281
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• 2016

This study was to investigate the correlation among swallowing function, dietary level, cognitive function, daily living, and comparison for general characteristics in stroke patients with dysphagia. Subjects of this study participated to 56 stroke patients with dysphagia. Outcome measures is evaluated by Functional Dysphagia Scale(FDS), and Amerian Speech-Language-Hearing Association National Outcomes Measurements System(ASHA NOMS), and Korean Mini-Mental State Examination(K-MMSE), and Korean Modified Barthel Index(K-MBI). Collected all data analyezed to independent t test for four assessments, and general characteristics of study subjects analyzed by pearson correlation coefficient for four assessments. Results of study, swallowing function according to lesion location differed significantly(p<.05). Cognitive function according to onset duration differed significantly(p<.05). Age of subjects and dietary level, cognitive function showed a significant correlation(p<.05). Swallowing function and dietary level, cognitive function showed a significant correlation(p<.05). Cognitive function and dietary level, daily living showed a significant correlation(p<.05). Based on current results, we suggest that swallowing rehabilitation for stroke patients with dysphagia performed with consideration for cognitive function and characteristic of patients.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.159-166
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• 2018

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.

• Therapeutic Science for Rehabilitation
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• v.8 no.3
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• pp.43-55
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• 2019

Objective: The purpose of this study is to conduct a preliminary research for the development of a Performance-Based Cognitive Function Test (PCFT) to screen the elderly for cognitive function impairment, and examine the reliability and validity of the test. Methods: A draft version of the Performance-Based Cognitive Function Test (PCFT) was developed and utilized in nine healthy elderly individuals. In order to verify its reliability, we analyzed the internal consistency of the PCFT. In order to verify the concurrent validity of the PCFT, this study analyzed the correlation between motor-cognitive dual task assessments and the Korean version of the Mini-Mental State Examination (MMSE-K). Results: The internal consistency of the PCFT for motor and cognitive tasks was 0.871 and 0.959 (Cronbach's ${\alpha}$), respectively. Concurrent validity of the PCFT, which was performed through motor-cognitive dual task assessments, ranged from 0.755 to 0.964 (Spearman's rho statistic, p < 0.05). In addition, correlation between the cognitive assessment tool and the MMSE-K ranged from 0.849 to 0.943 (p < 0.01). Conclusion: This study verified, and established the reliability and validity of the PCFT. Further studies are required to examine other psychometric properties in a modified PCFT, for screening cognitive function impairments in the elderly.

• Journal of Nutrition and Health
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• v.52 no.5
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• pp.465-474
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• 2019

Purpose: This study examined the association between the serum 25-hydroxyvitamin D concentration and the cognitive functions in Korean elderly. Methods: The subjects were 393 adults aged 60 years or older who participated in the Yangpyeong cohort between July 2009 and August 2010. The subjects were classified into deficiency, insufficiency, or adequacy groups according to the serum 25-hydroxyvitamin D concentration diagnostic criteria suggested by the US Institute of Medicine (IOM). The cognitive function was assessed based on the Korean version of the Mini-Mental State Examination (MMSE-KC). The dietary intake was assessed using the quantitative food frequency questionnaire with 106 food items. Results: The proportions of deficiency, insufficiency, or adequacy in serum 25-hydroxyvitamin D were 6.6%, 44.5%, and 48.9%, respectively. The serum 25-hydroxyvitamin D concentration was significantly higher in men than in women and in outdoor workers than in other occupations. The adequacy group had higher MMSE-KC scores than the other two groups, but not to a significant degree. The proportion of cognitive impairment tended to decrease with increasing serum vitamin D concentration to deficiency, insufficiency, and adequacy (p for trend = 0.029). The deficiency group had a 2.28 times higher risk of cognitive impairment than the adequacy group, but the difference was not statistically significant (OR, 2.28; 95% CI, 0.18 ~ 1.07, p for trend = 0.119). Conclusion: The serum vitamin D concentration tended to be associated with the cognitive function in elderly Koreans living in rural areas. To confirm the associations, further longitudinal studies with large samples were required.