• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.235-245
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• 2017

Purpose: Reported insomnia and decreased sleep quality are common among older adults. The purpose of this study was to identify factors contributing to insomnia and decreased sleep quality among elderly persons living within a community. The data will be verified with Actigraph which is a non-invasive measurement of rest/activity cycles. Methods: 137 participants over 65 years old were recruited from a senior welfare center. Their mean age was $74.07{\pm}5.18years$ old and majority was women (69.3%). The quality and quantity of nighttime sleep were assessed using Varren-synder-Halper Sleep Scale and a sleep log. Depression and fatigue were assessed using Geriatric Depression Scale Short Form and Fatigue Severity Scale, respectively. Pain was assessed using 11-point Numeric rating scale. An actigraph was used to verify the self-reported sleep. Results: Ninety-two participants (67.2%) reported insomnia. Sixty-eight subjects (49.6%) reported good sleep. Of the participants, 56.2% reported depression and 33.6% reported fatigue. In logistic regression, depression was related to insomnia (OR=3.09, p=.003). Sleep quality was related to depression (OR=2.13, p=.045) and fatigue (OR=2.24, p=.044). The data from the Sleep logs correlated with data obtained from the actigraph. Conclusion: Depression significantly influenced insomnia and sleep quality whereas fatigue only influenced sleep quality. Thus, depression and fatigue should be closely monitored among elderly persons with sleep disturbances.

• Korean Journal of Biological Psychiatry
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• v.21 no.2
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• pp.74-80
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• 2014

Objectives More than half of the elders suffer from chronic sleep disturbances. Moreover, sleep disturbances are more prevalent in patients with depressive disorder than in community dwelling elderly. In this study, we aim to estimate the risk factors of poor sleep quality and its effect on quality of life in patients with late life depression. Methods This study included 159 depressive patients aged 65 years or older who completed Pittsburgh Sleep Quality Index (PSQI). A global PSQI score of 5 or greater indicates a poor sleeper. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview (MINI). Depression was evaluated by the Korean form of Geriatric Depression Scale (KGDS). Global cognition was assessed by Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet. Quality of life was evaluated by the Korean version of Short-Form 36-Item Health Survey (SF-36). Results The frequencies of poor sleepers were 90.5% in major depressive disorder, 71.8% in minor depressive disorder, 47.1% in subsyndromal depressive disorder, and 73.0% in all types of depressive disorders. Multivariate logistic regression analysis indicated that female [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.20-6.67] and higher KGDS score (OR = 1.13, 95% CI = 1.05-1.21) were risk factors of poor sleep quality in patients with late life depression. In the analysis of ANCOVA adjusted for age, gender, education and KGDS score, the mean scores of vitality mental health and mental component summary of SF-36 were lower in poor sleepers than in good sleepers. Conclusions Poor sleepers among patients with late life depression are very common and are associated with female and higher KGDS scores. Poor sleep quality causes a significant negative effect on mental health quality. So researchers and clinicians should be more vigilant in the evaluation and treatment of sleep disturbances in patients with late life depression.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.53-59
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• 2019

Purpose : The purpose of this study was to determine the influence of the elastic-band exercise program for elderly who over 65 years old in terms of depression and physical self efficacy. We aim to suggest interventions with an elastic-band exercise program for elderly. Methods : The study subjects selected were females or males 65 years old or more who could walk without assistance and could talk about daily living without mental or physical disorders. A total of eight subjects understood the purpose of this study and agreed to participate. Before and after the exercise program, the subjects were monitored for changes in their physical self-efficacy and depression. To measure the physical self-efficacy, we used a perceived physical ability scale and physical self-presentation confidence scale (Cronbach α =0.942). To measure depression, we used the geriatric depression scale short form (Korea version, Cronbach α =0.969). The data obtained from each measure were analyzed using the Wilcoxon signed rank test to determine changes from before and after the exercise program. The program consisted of three parts (warm-up, main exercise and cool-down) and included the upper extremities, the lower extremities and trunk exercises with an elastic band (yellow and red). The program lasted for 15 weeks, once a week, with each session lasting for 60 minutes. Results : After 15 weeks of the elastic-band exercise program, there was a significant decrease on the depression scale (p<0.05) and significant improvements on the physical self-efficacy scale (p<0.05). Conclusion : Based upon our results, we demonstrated that the exercise program using the elastic band was effective in improving the depression and physical self-efficacy of the elderly.

• The Journal of the Korea Contents Association
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• v.9 no.10
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• pp.227-237
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• 2009

The purpose of this study was to determine the relationships with physical activity and depression and body function in elderly. Methods: Total 79 elderly(over 65years old) were participated in this study. A Korean Form of Geriatric Depression Scale(KGDS), Mini-Mental State Examination(MMSE-K), Jebsen hand function test, dynamometer, five time sit-up test were used to measure the depression and cognition, body function(hand function, grasp power, lower extremity strength). Results: Physical activity participated group shows higher in the body function and lower in the depression than non participated group. Conclusion: The findings of this study indicate that the physical activity is helpful to indicate and manage the depression and body function in elderly.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.3
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• pp.21-31
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• 2020

Purpose : The purpose of this study was to determine the effects of a cognitive-exercise program using step on the cognitive function, gait, and depression of elderly with mild cognitive impairment. Methods : The subjects comprised 30 elderly people with mild cognitive impairment who used elderly welfare centers in the provinces A, B, and C between March 21 and June 7, 2019. They were divided into an experimental group (n=15) and a control group (n=15) before undergoing an experiment based on a pretest-posttest control group design. The lowenstein occupational therapy cognitive assessment-geriatric population was used to assess the subjects' cognitive function, while the 4-stage balance test, 30-second chair-stand test, timed up & go test, and functional reach test were employed to evaluate their gait. In addition, the beck depression inventory was used to measure their levels of depression. Results : The cognitive-exercise program using step enhanced the subjects' cognitive function and gait and reduced their levels of depression. Furthermore, statistically significant differences were found between the experimental group and the control group. Conclusion : The cognitive-exercise program using step promoted the process of sensorimotor and cognition through the learning process of various steps taking left and right steps and cognitive activities. It improves gait by activating the coordination of the musculoskeletal and nervous systems of the body and positively affecting posture control, balance, flexibility, and lower extremity muscles. It also relieved depression by performing successful step learning and cognitive activities with forward-looking (doing) that leads to pleasure and achievement. The present study confirmed the value of a cognitive-exercise program using step to treat multiple domains of functional decline in elderly patients with mild cognitive impairment. This is therefore proposed as an intervention program for this patient group.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• The Journal of Korean Medicine
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• v.34 no.3
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• pp.106-118
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• 2013

Objectives: The aim of this study was to evaluate the effect of a mild cognitive impairment (MCI) management program on traditional Korean medicine in a public health center. Methods: In order to examine the effect of the MCI management program, we investigated MCI patients who participated in the program. MCI patients were treated with Jodeung-san (JDS) or Dangguijagyag-san (DGJYS) for 6 weeks. Mini Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Quality of Life-Dementia (GQOL-D), Geriatric Depression Scale in Korea (GDS-K), and biochemical examination of blood were conducted at intervals of 6 weeks. A satisfaction survey was collected after this program. Results: MMSE-DS mean score increased significantly, by 4.09 (p=0.000) in the JDS group and by 4.15 (p=0.000) in the DGJYS group. GQOL-D mean score also increased significantly, by 5.90 (p=0.000) in the JDS group and by 5.07 (p=0.000) in the DGJYS group. GDS-K mean score decreased significantly, by 10.63 (p=0.000) in the JDS group and by 9.69 (p=0.000) in the DGJYS group. MMSE-DS, GDS-K and GQOL-D scores were not significantly different between the JDS and DGJYS groups. All of the participants were satisfied with the program, and 90% of the participants expressed a high intention to participate in the program again. Conclusions: Both Jodeung-san and Dangguijagyag-san treatment showed improvement on cognitive function, depression and quality of life in this program. Additional studies with more subjects will be required to prove credibility and validity more clearly.

• Therapeutic Science for Rehabilitation
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• v.4 no.2
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• pp.84-91
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• 2015

The purpose of this study was introduce peer mentoring which is well used in various rehabilitation areas in overseas country to Korea academically and clinically and help psychological and physical recovery for stroke survivor. It was two group experimental design study, this protocol is designed for stroke survivor, 3-6 months after the onset. Peermentors were consisted of outpatients who is stroke survivor in different recovery levels, at least 2 year after the onset. Peermentors received education about how to support and mentor participants of the program emotionally, appraisally, and informationally and how to run the program. Geriatric Depression Scale Short Form-Korea Version(GDSSF-K) is used to measure psychological factor, Stroke Impact Scale(SIS) is used to measure recovery level of patient, and for physical factor Upper Extremity Function Test for the Elderly(TEMPA) was used. A researcher who is interested in the peer mentor program needs to find more effective applying method based on be offered method in this study for helping recovery after stroke.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.504-515
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• 2021

BACKGROUND/OBJECTIVES: Malnutrition risk and malnutrition among the elderly is a public health concern. In combating this health-related problem, it is critically important to evaluate the risk factors in a multidimensional way and to apply appropriate nutrition intervention based on the results. SUBJECTS/METHODS: A cross-sectional study was conducted on 215 elderly patients (32.6% male, 67.4% female) in a geriatric outpatient clinic of a hospital in Turkey. Nutritional questionnaires that incorporated the 24-h recall method were applied to determine general characteristics of patients, their health status, nutritional habits, and daily energy and nutrient intakes. Mini Nutritional Assessment was used to determine nutritional status. Relevant anthropometric measurements were obtained. RESULTS: The subjects' mean age was 76.1 ± 7.0 years, and the prevalence of malnutrition (n = 7) and risk of malnutrition (n = 53) among the 215 subjects was 3.2% and 24.7%, respectively. Patients with malnutrition or risk of malnutrition were found to be single, have a depression diagnosis, in an older age group, have less appetite, more tooth loss, have more frequent swallowing/chewing difficulty, and have more frequent meal skipping. In addition, mean daily energy, carbohydrate, fat, fiber, vitamin E, vitamin B1, vitamin B2, vitamin B6, vitamin C, folates, potassium, magnesium, phosphorus, iron intake, and water consumption were found to be statistically significantly low in subjects with malnutrition or risk of malnutrition. After performing regression analysis to determine confounding factors, malnutrition risk was significantly associated with marital status, loss of teeth, appetite status, and depression. CONCLUSIONS: Routine nutritional screening and assessment of the elderly should be performed. If nutritional deficiencies cannot be diagnosed early and treated, self-sufficiency in the elderly may deteriorate, resulting in increased institutionalization.

• 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.