This study has several limitations. First, we did not examine all the possible risk factors that are related to poor cognitive func- tion, such as genetic factors (e.g., APOE), depression, the amount ofcognitive leisure activity, or sleep and nutritional status. Sec- ond, we did not have any information about the compliance of participants with treatment for cardiovascular diseases or other comorbidities. Third, the types of insurance and risk factors for cognitive decline were measured only at the baseline. Fourth, the proportion of participants receiving MA services (10.1%) in our study is higher than that oftheelderly aged 60 years or old- er (7.2%) in Korea (15). On one hand, this may be a selection bias that impacts our results, but on the other hand, the partici- pants in our study may better represent the characteristics ofthe individual lower SES. Finally, local tax of each district may not represent the quality of environment such as accessibility to a community center, which also might influence cognitive func-
인구사회학적 특성으로는 성별, 연령, 결혼상태, 교육수 준을 고려하였으며 건강행태는 흡연여부, 고위험음주 여부, 신체활동 여부로 구성하였고 심리적인 요인으로는 우울정 도를 모델에 투입하였다. 이 중 흡연여부는 비흡연, 과거흡 연, 현재흡연으로 구분하였고 고위험음주 여부는 비음주, 저 위험음주, 고위험음주로 하였다. 고위험음주는 남자의 경우 1회에 7잔 이상으로 여자의 경우 5잔 이상으로 하였다. 우울 정도는 단축형 노인우울척도(Short form of Geriatric Depression Scale: SGDS) 15문항을 사용하였다. 본 연구에서 Cronbach‘s
Until now, the effect of brain volume, as estimated by head circumference, andthe level ofcognitivefunction in normal elderly as well as in patients with Alzheimer’s disease, has been discussed controversially. Evidence supporting a cogni- tive reserve resulting from large brain volume showed that lower brain volume is correlated with cognitive impairment andthe onset of Alzheimer’s disease [8-11]. However, there are studies that do not support this theory [12-14]. Depression may advance cognitive dysfunction while cognitive dysfunc- tion commonly accompanies symptoms ofdepression. Aging can cause frontal lobe atrophy which may, in turn, result in the development ofdepression [15,16]. Therefore, it is im- portant to evaluate depressive symptoms as well as cognitive symptoms in studies of dementia.
During the intervention period, band therapy was provided with music. For the first time, the same music was provided four times in a row, and this may have bored the participants. For future studies, depending on participants’ music preferences, a diverse variety of music needs to be provided with the band therapy from the outset. In addi- tion, even participants with poor cognitivefunction can follow the beat of percussion instruments for the exercise, and so future studies are highly encouraged to use percus- sion instruments, and it is further encouraged for band therapy to indicate the start and direction of each motion in the exercise.
Depression andcognitivefunction are seen as interrelated factors, although this view is open to dispute (Clement et al ., 2009).
Oddly, depression in old age tends to be overlooked because it frequently coexists with other age-related physical disorders. Moreover, older Korean individuals often highly value modesty and refrain from expressing their emotions because of their adherence to Confucian beliefs and traditions (Jang et al ., 2005). The importance of early detection and timely intervention ofdepression does not need further emphasizing. Outreach efforts geared toward depressed older adults reluctant to seek help from others are believed to be strategically effective in reducing suicide risks among these individuals (Oyama et al ., 2008). Society plays a crucial role in this regard. Its enthusiasm in reaching depressed older adults with the help and support they need is fundamental, as these individuals do not tend to seek help voluntarily. There are an anticipated 62 thousand government-established welfare facilities for senior citizens throughout South Korea to data, and this number is steadily rising (Korea Ministry of Health and Welfare, 2011). Due to their high accessibility to community-dwelling older adults, these facilities have increasingly been receiving attention with regard to their suitability as health screening and promotion venues (Kim and Song, 2006). However, the activities conducted and services provided at these centres remain primarily recreational and social. Therefore, the purpose of this study was to investigate the prevalence ofdepressionand suicidal ideation in community-dwelling older adults who regularly visited a senior welfare centre in Korea, as well as identify associated factors, including cognitive impairment.
Although many studies on the effect ofcognitive training in MCI patients have been published andthe effect of our cognitive program has been proven in pre- vious reports, our study has several unique aspects: ﬁrst, our program was home-based, which can increase adherence. 26 In Korea, most patients with dementia can- not receive non-pharmacological intervention because ofthe high cost and lack of infrastructure. HCI is self- directed learning, which can be easily assessed and enables long-term training. 27 Furthermore, our results suggest that cognitive training has a delayed effect on cognition that lasts for 3 months after ﬁnishing the program. Second, we found that cognitive training improved scores for executive functionanddepression, which differs from previous studies. 28 Finally, our study is a prospective trial investigating changes in brain meta- bolism after cognitive training in MCI patients. Although we failed to prove statistical signi ﬁcance, our results showed a high tendency toward increased brain metabo- lism. MCI is a neurodegenerative disease that is slowly progressive; therefore, 12 weeks for cognitive training may not be enough time to change brain metabolism.
2 Department of Nursing, Kyungwoon University
3 Department of Nursing, Keimyung College University
요 약 본 연구는 지역사회 거주 허약 노인을 대상으로 우울, 주관적 건강상태, 건강증진행위 정도를 알아보고, 건강증진 행위에 영향을 미치는 요인을 확인하기 위해 시도되었다. 연구대상은 D지역 재가 방문 서비스를 받는 대상자 중 65세 이상의 허약 노인 164명이었으며, 2020년 1월부터 2월 21일까지 설문조사를 실시하였다. 분석방법은 SPSS/WIN 23.0 프로그램을 이용하여 연구대상자의 일반적 특징 분석, independent t-test, one-way ANOVA분석, Scheffe test 사후 검정, 상관관계 분석, 단계적 다중회귀분석(stepwise multiple regression)을 실시하였다. 연구결과는 다음과 같다. 우 울은 10.67점, 주관적 건강상태는 6.71점, 건강증진행위는 2.59점으로 나타났고, 건강증진 하위영역별 점수는 영양이 2.83점으로 가장 높았고, 스트레스 관리가 2.06점으로 가장 낮았다. 건강증진행위에 대한 우울은 유의한 음의 상관관계 가 있었으며, 주관적 건강상태는 양의 상관관계가 있었다. 대상자의 건강증진행위에 영향을 주는 요인은 연령, 교육수준, 우울로 나타났고 이 변인들은 건강증진행위를 73.6% 설명하였다. 본 연구를 통해 우울이 허약 노인의 건강증진행위에 영향을 미치는 요인임을 규명함으로써 허약 노인이 장애 노인으로 진행되는 것을 예방하기 위해 우울 중재가 포함된 다양한 프로그램 통한 허약 노인의 건강증진행위를 지속시키는 것이 중요할 것이다.
(AOR = 1.206).
The estimated fall rate increased by 3.9% from 2011 to 2014, but subsequently drastically dropped by 9.2% from 2014 to 2017. It seemed worthy of a further investigation to discover potential reasons for this sudden drop of fall rate in 2017. To begin with, we examined the par- ticipants’ physical conditions including subjective health condition from KNSELCWD (2011, 2014, & 2017) and determined that physical functionality and subjective health condition did not have any significant differences over the study period. Yet, KNSELCWD examined the impaired level ofcognitive functionality ofthe Korean elderly people using a Korean version
Objectives: This study aimed to analyze the correlation between oral function, oral environment, and brain cognitivefunction in theelderly. Methods: The subjects were 60 users of senior community center andelderly day care center. The survey was conducted from November to December 2018. Subjects were assessed by oral examination and myofunction test. Oral myofunction was measured using IOPI R and Lip de Cum R . Survey data were analyzed using the statistical programs of PASW Statistics ver. 18.0. Results: Tongue muscle strength and lips muscle strength was higher in males than in females. The tongue and lip strengths were higher in the <81 years old group than the ≥81 years old group. Functional tooth analysis showed that there was a ≥15 teeth group (40.91±7.36) and a <15 teeth group (32.52±7.14).
그러므로, 최근 갑작스런 체질량 지수 변화가 있는 노인들의 인지 장애 예방을 위하여 이들에 대한 영양관리 및 걷기 운동 프로그램의 적용이 필요하다.
• 주제어 : 노인, 인지, 체중변화, 체질량 지수변화, 걷기 운동
Abstract A descriptive research is studied to identify the physical factors affecting to cognitivefunction among elderly residents over 65 years old in a community. The data were collected from 352 participants as part of a health-related survey by home visits in Seoul in 2010-2012. Their cognitivefunction was measured using the Korean form of Hasegawa Dementia Scale(HDS-K) andthe collected data were analyzed by using t-test, ANOVA, and multiple regression analysis. From the analysis, the prevalence rate ofcognitive impairment was 13.6%. Elderly residents in a community showed different cognition levels by the status of age, change of weight, change of BMI, walking and flexibility exercise.
our study were limited. Second, we considered not only age, gender, education, household income, residential area, smoking and drinking, which are known to be risk factors for depression, but also used reliable information to make adjustments for comorbidity, disability, cognitive decline, and baseline depressive symptoms. Finally, we were able to provide a possible implication for community mental health services. Specifically, the frequency of contact between theelderlyand adult children is a bidirectional variable and we suggested an intuitive and realizable cut-off of at least 1 phone call a week and at least 1 visit a month. As a result, it is relatively easy to develop an intervention that includes components such as a social promotion campaign, family education, etc. However, this cut-off point should not be taken as absolute value because other factors such as the sociocultural characteristics of a nation, local characteristics and technology level would have to be considered.
Full explanation can be found at http://cgv.kaist.ac.kr/brain/, andthe toolbox that implements each step can be accessed from http://
www.nitrc.org/projects/dtmframework/. In principle, hippocampal binary masks were input to a non-rigid shape modeling framework (i.e., DTM framework) that uses a progressive model deformation technique built-up on a Laplacian surface representation of multi- level neighborhood and ﬂexible weighting scheme ( Kim et al., 2015). Brie ﬂy, the surface of a 3D model that encodes the generic shape characteristics of all hippocampi from the sample as a triangular mesh is non-rigidly deformed in a large-to-small scale to allow recovery ofthe individual shape characteristics, while mini- mizing the distortion ofthe general model ’s point distribution. This surface deformation is achieved through an iterative process that, at each iteration, decreases a rigidity weight a andthe level of neighborhood in a step-wise way together with the magnitude ofthe displacement of each vertex. At early iterations, the generic 3D model deforms more largely to reproduce the large shape features ofthe hippocampus by propagating the external force, guiding each vertex ofthe general model to the closest image boundary, across the surface. In the iteration process, when the general model is not deformed anymore by the balance between the external and in- ternal forces, the rigidity andthe level of neighborhood are grad- ually diminished so that the model deforms at smaller regions to reproduce local shape details. To preserve the surface quality and diminish the effect that rough boundaries and noise in the binary masks could pose to the shape analyses, a rotation and scale- invariant transformation that constrains the vertex trans- formations only to rotation, isotropic scale, and translation is applied afterward. This helps regularizing the individual vertex transformations to those ofthe neighboring vertices using them as reference.
This study had potential limitations, in addition to those presented in our previous study. First, our study was observational in nature and cannot prove causality.
Although we attempted to control for the effects ofthe major identified predictors ofcognitivefunction, B vitamins consumption could be a marker for unrecognised factors that affect cognitivefunction. Second, results may be difficult to interpret and apply to the general population, as a random sample was not utilized. Third, holotranscobala- mine, a better indicator of vitamin B12 status, was not measured; and serum vitamin B2 and B6 levels were not measured, only data on dietary intake. Despite limitations, and to the best of our knowledge, this is the first study investigating the relationship between cognitivefunction scores and dietary intake by cognitive status.
이 연구에서는 우리나라 지역거주 노인의 포괄적인 낙상위험 요소를 평가하기 위한 문항을 선정하고 유효성
을 검토하였다. 낙상위험 평가는 선행연구를 참고로 '낙 상잠재성', '신체기능', '질병과 신체증상', '환경', '행동 과 성격'의 5가지 요인으로 구분하였으며 내용타당성 검 증, 교차분석 및 요인분석 결과에 따라 총 44개 문항으로 구성하였다. 이 연구에서 검증된 결과를 토대로 후속 연 구에서 고려되거나 해결되어야 할 과제를 제언하면 다음 과 같다. 첫째로 다양한 지역과 종단적 데이터 수집을 통 해 연구결과를 일반화 시킬 필요가 있을 것이다. 둘째 다 중회귀분석, 확인적 요인분석, ROC분석 등의 추가적인 통계분석을 실시하여 다양한 관점에서 타당성을 검증하 고 기준치 작성을 위한 검토작업이 필요할 것이다. 셋째 Table 6. Contents ofthe questionnaire.