• Korean Journal of Biological Psychiatry
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• v.20 no.2
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• pp.45-53
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• 2013

Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.678-693
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• 1993

The purposes of this study were to describe the level of vision and hearing impairments, depression and functional capacity, among Korean institutionalized elderly and to examine the relation-ship between sensory impairments, depression, and functional capacity in these people. The final pupose was to test the cognitive function path model using sensory competencies as predictors. A convenience sample of thirty nine male and 90 female subjects with a mean age of 80.5 were the subjects of this study. The subjects were tested for cognitive function, and vision and hearing impairments. Physical function and social function were measured by observation of designated task performance by the subjects. Their level of de-pression was measured using a Geriatric Depression Scale administered through an interview. Individual subjective ratings of hearing and vision were marked by the subjects, on a ladder scale. The results of the study showed that 48.8% of the subjects had a hearing impairment, 63.5% had a vision impairement, and 36.4% had both a vision and hearing impairement. The four sensory groups (no sensory impairement, hearing impairement, vision impairement, hearing and vision impairement) were tested for differences in depression, physical function, social behavior and cognitive function. The only significant difference that was found was in cognitive function, between the no sensory impairement group and the hearing and vision impairement group(F=3.25, P<.05), Subjective ratings of hearing showed a significant correlation with cognitive function(r=.34, p<.001) and with social behavior(r=.31, p<.001). There was no correlation between subjective vision ratings and cognitive function or social behavior. However there was a significant correlation between vision and hearing(r=.49, p<.001). There was also a significant negative correlation between age and vision(r=-.21, p<.01) and between age and hear-ing(r=-.34, p<.001). There was a significant correlation between depression and physical function (r=-.32, p<.001) but there was no correlation between depression and cognitive function or social behavior. Based on the literature review and the result, this study, a path model of sensory competence-> cognitive function- >social behavior was developed and tested : Perceived vision and perceived hearing were the exogenous variahles and cognitive function and social behavior were the endogeneous variables in the model. The path analysis result demonstrated an accept-able fit (GFI=.997, AGFI=.972, X$^2$=.72 (p=.396), RMSR=.019) between the data and the model. There was a significant direct effect($\beta$=.38) of perceived hearing on cognitive function. There was a significant direct effect ($\beta$=.32) of cognitive function on social behavior. The total effect of hearing on social behavior was $\beta$=.32 including the indirect effect ($\beta$=.12) . However perceived vsion had little effect ($\beta$=-.08) on cognitive function. The result of path analysis confirms that hearing levels influence cognitive function, and both hearing and cognitive function levels influence social behavior. However, vision has little effect on cognitive function or on social behavior. For the next study, a combined model of the pre viously developed environment - >depression- > physical and social function model, and the present cognitive function model, should be tested to further refine the functional capacity model. There also a need for longitudinal study of functional capacity and sencory competence in order to better understand how declining sensory competence influences functional capacity and how it effects in-creasing dependency and nursing needs in the elderly.

• Korean Journal of Biological Psychiatry
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• v.21 no.3
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• pp.107-113
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• 2014

Objectives Restless legs syndrome (RLS) is a sleep disorder characterized by uncomfortable and unpleasant sensations in the legs and an urge to move the legs, usually at night. The aim of this study is to investigate the incidence of RLS in patients with late life depression and its influence on various clinical outcomes such as severity of depression, sleep quality, cognitive function, and quality of life and accordingly, to elucidate the clinical significance of RLS in patients with late life depression (LLD). Methods This study enlisted 170 depressive patients aged 65 years or older from an outpatient clinic. Structured diagnostic interviews were performed using the Korean version of the Mini-International Neuropsychiatric Interview. All patients completed the questionnaires, including the International RLS Severity Scale, the Korean version of Short-Form 36-Item Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). The severity of depression was evaluated by the Korean form of the Geriatric Depression Scale (KGDS) and the level of global cognition was assessed by the Mini-Mental State Examination in the Korean version of The Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (MMSE-KC). Results The incidence of RLS was 17.6% in LLD patients. RLS was more prevalent among the subjects with major depressive disorder (MDD) than those with minor depressive disorder or subsyndromal depressive disorder. The RLS group showed higher score in the KGDS than the Non-RLS group but the difference did not reach the statistical significance (p = 0.095, Student t-test). The mean PSQI score was significantly higher in the RLS group than in the Non-RLS group (p = 0.001, Student t-test). The MMSE-KC score was also lower in the RLS group than in Non-RLS group (p = 0.009, analysis of covariance). But, there was no difference in the score of SF-36 between the RLS group and the Non-RLS group. Conclusions RLS is common in LLD patients, especially in the patients with MDD and is associated with poor sleep quality and cognitive dysfunction, indicating that RLS is clinically significant in patients with LLD. Therefore, RLS should be considered as an important clinical issue in the management of LLD.

• 한국노년학
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• v.34 no.2
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• pp.247-258
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• 2014

The aim of this study was to investigate the influence of resilience and depression on suicidal ideation in elderly. The survey was conducted by 335 subjects (aged 65 to 70 years old; both gender) living in Daegu and Gyeongbuk district. Data were collected through interview-based questionnaires which were constructed to include the general characteristics(8 items), suicidal ideation(19 items), depression(15 items), and resilience(27 items). Collected data were analyzed by frequency, t-test, one-way ANOVA, and regression analysis. The present results showed that the main general factors affecting the resilience of elderly were age, the type of dwelling, pin money, and health. The influencing factors on suicidal ideation were health status, depression level, and the resilience in elderly. In particular, the suicidal ideation was more affected by self-regulation and affirmation of the subcategory in resilience. In conclusion, the resilience and depression is need to be considered as one of the main factors for decreasing the suicidal ideation in elderly.

• Journal of Korean Biological Nursing Science
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• v.19 no.3
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• pp.170-177
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• 2017

Purpose: This study was to identify factors influencing the quality of sleep in elderly women with urinary incontinence and examine the relationship among the factors. Methods: The study investigated 113 elderly women with urinary incontinence who were subject to the visiting care program at health centers in D-gu, D-si, South Korea. The collected data were analyzed using IBM SPSS version 19.0 along with ${\chi}^2-test$, t-test, ANOVA, Pearson's correlation, and multiple regression. Results: The total Pittsburgh Sleep Quality Index (PSQI) of the participants was found to be $11.41{\pm}4.34$. As a result of the correlation analysis, PSQI was found to have significant correlations with Female Lower Urinary Tract Symptoms (BFLUTS) (r= .32, p< .001). The Korean version of Physical Activity Scale for Elderly (K-PASE) was (r= -.34, p< .001) and the Geriatric Depression Scale Short Form (GDS-SF) was (r= .23, p= .012). Multiple regression analysis found sleeping pill use (${\beta}=-.35$, p< .001) had the strongest influence on PSQI, followed by physical activity (${\beta}=-.20$, p< .001), depression (${\beta}=.20$, p< .001), and lower urinary tract symptoms (${\beta}=.19$, p< .001). The total model explanatory power was 28.3% (F= 12.07, p< .001). Conclusion: The study findings are expected to be useful for enhanced understanding of the quality of sleep in elderly women with urinary incontinence.

• Health Policy and Management
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• v.9 no.3
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• pp.95-112
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• 1999

The objectives of this study were to develop the therapeutic recreation programs for relieving depressive symptoms of the elderly and to verify the effect on their psychological condition. The key elements of these programs, which consisted of 9 sessions. were aerobic exercises, group dynamics. and making fun. These programs were developed through a multidisciplinary approach with social workers and the faculties of preventive medicine. The social workers gave these programs to fifteen elderly people at the community center, so called noinjung, for 9 weeks. Before intervention of this program for the experimental group, the baseline was measured by GDS(geriatric depression scale). After intervention for 9 weeks, GDS as an outcome was measured to evaluate the effects of the program. This data was analyzed by $X^2$-test and Wilcoxon signed rank test. and the results were as follows: 1. Based upon the cutting point(GDS = 5) which could distinguish between depression group and normal group, the number for the normal group increased, while the number for the depression group decreased slightly after intervention with the therapeutic recreation programs, however, there was no significant change(p〉0.05). 2. The score of GDS decreased significantly after intervention with the therapeutic recreation programs(p〈0.05). 3. The scores of GDS decreased in widow(or) group and in female group compared to those of the married group and the male group, respectively(p〈0. 05). 4. The score of GDS increased in groups with similar labor and emotional support compared to those of groups with sufficient or less support, respectively(p〈0.05), These findings indicate that the therapeutic recreation programs might be effective for relieving depressive symptoms of the elderly. It is, therefore, suggested that this program be modified and standardized through review of the intervening process, experimental results, and responses of clients for appling in other noinjungs.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.131-139
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• 2020

Objective: The purpose of this study was to evaluate the effect of virtual reality (VR)-based core stabilization exercise on upper extremity function, postural control, and depression among persons with stroke with hemiplegia. Design: Randomized controlled trial. Methods: This study was conducted with the inclusion of 24 participants and were randomly assigned to either the VR-based trunk stability exercise group (n=12) or control group (n=12). The VR-based trunk stability exercise group performed core stabilization exercises in a VR environment for 30 minutes. Meanwhile, the control group conducted general core stabilization exercises for 30 minutes. The participants trained 3 times a week for 4 weeks. The manual functional test (MFT), Box and Block Test (BBT), Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), the Geriatric Depression Scale (GDS) were used to assess all participants before and after the intervention. Results: The VR-based core stabilization exercise group had a significant improvement in upper extremity function (MFT, BBT) and postural control (BBS) compared with the control group (p<0.05). The VR-based core stabilization exercise showed a significant difference after intervention in the TIS and GDS scores (p<0.05), but they did not significantly differ between the two groups. Conclusions: The result showed that VR-based core stabilization exercise can be effective in improving upper extremity function and postural control among patients with stroke more than the sole application of general physical therapy.

• Journal of Oriental Neuropsychiatry
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• v.22 no.4
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• pp.101-109
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• 2011

Objectives : The aim of this study was to evaluate the effects of EFT-I(EFT program for insomnia) for insomnia in the elderly as a preliminary study. Methods : This study was a single group pre-post comparative study that involved 10 elderly women(mean age=$76.3{\pm}4.29$), who visited a senior welfare center, complained of insomnia symptoms. Subjects received 8 sessions(twice a week for 4 weeks and 1 hour for each session) of EFT-I group training. Insomnia severity, depression, state-anxiety, and life satisfaction of each subject were evaluated twice at pre and post of EFT-I. Korean Sleep Scale, Short form of Geriatric Depression Scale(SGDS), State-Trait Anxiety Inventory(STAI), and life satisfaction scale were used as evaluation tools. The data were analyzed using paired-samples T-test. Results : Insomnia severity, life satisfaction, depression, and state-anxiety were significantly improved by EFT-I. Conclusions : Result of this study showed that EFT-I can be a useful treatment program for elderly insomnia. Larger clinical trials are needed to verify effect of EFT-I as a community based insomnia management program for the elderly.

• The Korean Journal of Health Service Management
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• v.5 no.2
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• pp.173-186
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• 2011

The purpose of this study was to know dysfunctions degree, daily living activity, depression and quality of life among stroke elderly person; and to know what kind of factors affecting to quality of life of the stroke elderly person; after that provide a fundamental data to nursing arbitration plan about increase height quality of life of the stroke elderly person. The study subjects were collected 119 people, over than 60 age, who were diagnosed with stoke in D hospital, living in B city. The data was collected by using personal interviews and questionnaire, from Nov 2008 to Jan 2009. The questionnaire were Pre-Stroke MRDS(Modified Rankin Disability Scale), Barthel-ADL(Activities of Daily Living), K-IADL(Korean-Instrumental Activities of Daily Living), GDS-15(Geriatric Depression Scale-15-question form) methods. The pre-stroke MRDS was appeared a functional obstacle. The mean score of activity of daily living was 18.24 which showed the subjects were mildly disabled, the score of instrumental activities of daily living was 7.94 which showed the mildly abled, and score of depressiveness was 7.41 which showed the subjects were mildly depression. There was a significantly correlation among MRDS, ADL, IADL, depressiveness and quality of life. Through these study result, important to check the old subjects' depressiveness, cognitive functions, daily living abilities, dysfunctions degree to main tain their quality of life.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.15-21
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• 2013

Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.