지역사회에 거주하는 치매 노인, 주관적 경도인지장애 노인, 건강한 노인의 인구학적 특성, 건강증진활동 비교

황은정 한국산학기술학회 2022 한국산학기술학회논문지 Vol.23 No.7

This study aimed to compare the demographic characteristics and health promotion activities, depression, subjective health status, and quality of life between older adults with dementia, mild cognitive impairment (MCI), and healthy older adult residents in the community. The subjects of this study were 61 older adults with dementia, 933 older adults with MCI, and 2,338 healthy older adults comprising the final 3,332 samples, selected from the '2019 Community Health Survey' data. Among the criteria for subject selection, age was an important factor in cognitive impairment, so the age of the subjects was limited to 75 years. For data analysis, descriptive statistical analysis, the chi-square test, and ANOVA were used. The results of this study showed that there were significant differences between the three groups in terms of general characteristics such as gender, education level, and basic livelihood beneficiaries (p<.001). In relation to health promotion activities, there were significant differences in exercise performance, subjective health level, depression, and quality of life (p<.001). In this study, the factors that had a significant effect on dementia or MCI in elderly subjects were education level (OR=1.66, 95% CI=1.05-2.64), subjective health level (OR=0.80, 95% CI=0.72-0.88) and depression (OR=1.13, 95% CI=1.10-1.16). Through the results of this study, it was confirmed that there were differences in demographic characteristics and health promotion activities among the older adults with dementia, older adults with MCI, and healthy older adults. Therefore, a customized dementia prevention program and a cognitive enhancement program should be developed in consideration of the varied characteristics of the subjects. In future research, we propose a continuous study comparing a range of factors between dementia patients and healthy subjects. 이 연구의 목적은 지역사회에 거주하는 치매노인, 경증인지장애 노인, 건강한 노인을 대상으로 인구학적 특성과 건강증진활동을 비교하는 것이다. 이 연구는 ‘2019년 지역사회 건강조사’ 자료를 활용하여 75세 대상자로만 추출하여, 치매 대상자 61명, 경증인지장애 대상자 933명, 건강한 대상자 2,338명으로 최종 3,332명을 선정하였다. 대상자 선정기준은 연령이 인지장애에 중요한 요인으로 작용함으로 연령을 보정하여 75세 대상자로 한정하였다. 자료 분석은 기술통계 분석, Chi-square test, ANOVA를 활용하였다. 이 연구결과에서 세 집단의 인구학적 특성에서는 성별, 교육정도, 기초생활수급권자 여부에서 유의한 차이를 보였다(p<.001). 건강증진활동과 관련하여 신체활동, 주관적 건강수준, 우울, 삶의 질에서 유의한 차이를 보였다(p<.001). 이 연구결과에서 노인 대상자의 치매 또는 경도인지장애에 유의한 영향을 미친 요인으로는 교육정도 (OR=1.66, 95% CI=1.05-2.64), 주관적 건강수준(OR=0.80, 95% CI=0.72-0.88), 우울(OR=1.13, 95% CI=1.10-1.16)인 것으로 나타났다. 이 연구결과를 통해 치매 노인, 경증인지장애 노인, 건강한 노인 간에 인구학적 특성과 건강증진활동 간에 차이가 있음을 확인하였다. 그러므로 대상자의 다양한 측면을 고려한 맞춤형 치매예방 프로그램과 인지강화프로그램이 개발되어야 할 것이다. 향후 연구에서는 치매대상자와 건강한 대상자의 다양한 요인을 비교하는 지속적인 연구를 제안한다.

인지장애노인의 요실금에 대한 고찰

류세앙 동신대학교 2006 論文集 Vol.16 No.-

This research was performed to review on urinary incontinence of the cognitively impaired older adults. There was use of diaper or habits practice for a management of urinary incontinence that is one of major problem in nursing at the long term care facilities, which could lead to a physical and emotional problem of the patients and caregivers. Self-management strategies like pelvic muscle exercise and biofeedback were proved the effectiveness on urinary incontinence who were the cognitively intact and ambulatory adult. However it is difficult to apply those for the cognitively or physically impaired elderly as the strategies need cognitive ability for learning and performing, Because of this limitation, caregiver-dependent strategies like scheduled toileting, habit training and prompted voiding are usually recommended for management of urinary incontinence of the cognitively impaired older adults. Prompted voiding involves asking residents at regular intervals if they need to void and if so, they are helped in toileting, which is to assist them to void using appropriate toileting receptacles before the resident urinate involuntarily on the clothing, bed or diaper. So it has advantage of involving the elderly in decision making of their care, and has merit of keeping dignity of individual as they maintain almost normal voiding. Conclusively, this implies that the individual could maintain a certain level of continence if appropriate toileting opportunity given, although the elderly has impaired cognition and mobility. But, Important factors of successful implementation of prompted voiding were as followed. First, there must be a subject selection process for appropriate for prompted voiding. Second, identify subject's voiding pattern and schedule individually. Lastly, give a positive feedback, when the resident request toileting assistance, or maintain continence status, or use toileting receptacles properly. I hope to develope a practical prompted voiding protocol based on this results and to perform it for cognitively and physically dependent older adults.

한국 노인의 상지근력과 인지기능 사이의 상관관계 융복합 연구

최원재 한국융합학회 2020 한국융합학회논문지 Vol.11 No.2

The aim of this study was to examine the relationships between upper limb muscle strength and cognitive function in older Korean adults. A total of 130 Community-dwelling older adults, who were able to independently conduct activities of daily living, participated in the study. We assessed upper limb muscle strength using a handgrip strength and arm curl test, and their cognitive function using a Montreal cognitive assessment (MoCA) and general practitioner assessment of cognition (GPCOG) tests. Out of 130 participants, 26 (20%) had normal cognitive functions, while 104 older adults (80%) had mild cognitive impairments (MCI). Handgrip strength was significantly different between older adults with and without MCI (p<.05) and was related to MoCA and GPCOG (p<.05). In the result, there is a correlation between physical ability and cognitive function of the older adults. Therefore, it is necessary to develop exercise program to improve mental health. 본 연구의 목적은 한국 노인의 상지 근력과 인지기능 사이의 상관관계를 알아보기 위해서 실시하였다. 지역사회에 거주하는 노인 중 독립적으로 일상생활이 가능한 130명이 본 연구에 참여하였다. 참여자들의 상지 근력은 악력과 아령 들기 검사로 평가하였고 인지 기능은 몬트리올 인지평가 도구와 실무자용 노인인지기능 사정도구를 사용하여 평가되었다. 연구 결과 130명의 노인 중 26명(20%) 만이 인지 기능이 정상이었고 104명(80%)은 경증인지장애를 가지고 있는 것으로 나타났다. 노인의 상지 근력 중 경증인지장애 유무에 따라 악력에서 유의한 차이가 있었고(p<.05), 악력은 몬트리올 인지평가 도구와 실무자용 노인인지기능 사정도구와 유의한 상관관계가 있었다(p<.05). 본 연구 결과, 노인의 신체적 능력과 인지기능 사이에 상관관계가 있기 때문에 정신건강을 향상시키기 위한 운동프로그램의 개발을 추후 필요할 것이다.

Efficacy of Immersive Virtual Reality-Based Cognitive Training in Older Adults with Hearing Impairment: Three Case Reports

Soo Jung Lee,이성민 한국청각언어재활학회 2022 Audiology and Speech Research Vol.18 No.1

The purpose of this study was to investigate the effects of immersive virtual reality (VR)-based cognitive training in older adults with hearing impairment. Participants were three older adults with hearing impairment. Three assessment tools, audiometric, neuropsychological, and outcome measurements of the subjective hearing handicap inventory for the elderly, were examined before and after the VR cognitive training. The VR cognitive training was conducted once per week for 6 weeks and consisted of five different VR games classified into three specific cognitive domains (attention, memory, and executive function). The improved VR game performances were constantly observed across the training sessions in all three participants. After the VR cognitive training, first, the scores on the forward digit span test (attention), immediate recall on the SVLT-E (memory), and word reading and color reading on the K-CWST (executive function) were improved for all participants. In addition, the reaction time on the K-TMT-E (executive function) was shortened. Second, the sentence recognition scores in adverse listening conditions (SNR 0 dB and -5 dB) were improved. Third, the Korean version of hearing handicap inventory for the elderly (K-HHIE) scores which are reflective of subjective hearing handicap were decreased. Preventive intervention for cognitive deficits in older adults with hearing impairment is needed because hearing impairment is one of the major risk factors for dementia in older age. In this respect, the present case study demonstrates that VR cognitive training could improve cognitive function, speech-in-noise perception, and subjective hearing handicap in the hearing-impaired elderly.

경도인지장애노인의 목공치유프로그램 참여 경험 연구

이현주(Lee, Hyun-Joo),김상희(Kim, Sang-Hee),반시우(Ban, Si-Woo),전명옥(Jeon, Myoung-Ok),신혜리(Shin, Hye-Ri),김영선(Kim, Young-Sun) 고령자치매작업치료학회 2021 고령자.치매작업치료학회지 Vol.15 No.2

목적 : 본 연구는 경도인지장애 노인에게 목공치유프로그램을 적용하여 프로그램이 노인의 참여경험에 미치는 영향을 질적 연구를 통해 살펴보고자 한다. 연구방법 : 연구대상은 S시 치매안심센터 이용 65세 이상 경도인지장애 등급을 받은 노인 12명으로 목공치유프로그램을 2021년 6월부터 7월까지 주2회 총 10회기 대면으로 진행하였다. 프로그램 종료 후 12명 중 중도탈락한 3명을 제외하고 최종 9명에게 전화 면담을 실시하였다. 연구결과 : 경도인지장애 노인의 목공치유프로그램 참여 경험에서 의미화 및 패턴을 4개의 주제별로 범주화하였다. 첫째, 직접 만든 작품으로 자신감과 자존감을 회복하였다. 둘째, 목공활동이라는 새로운 경험과 추억을 통해 삶의 활력을 얻었다. 셋째, 작품 완성을 통해 자신의 기능과 가능성을 확인하였다. 넷째, 배움에 대한 욕구를 파악하고 사회적 관계를 형성하였다. 결론 : 목공치유프로그램은 경도인지장애 노인의 참여 경험에 긍정적인 영향을 미치는 것을 확인하였다. 본 연구 결과를 토대로 경도인지장애 노인을 위한 목공치유프로그램의 지속적인 개발과 지역사회 보급을 위한 공공적 지원이 필요하며, 후속 연구에서 목공치유프로그램에 대한 양적, 질적 효과성을 검증하는 다차원적인 연구가 이루어져야 할 것이다. Objective : The purpose of this study is to examine the effect on the participation experience of the older adults by applying the woodworking program to the older adults with mild cognitive impairment. Methods : The subjects of this study were 12 older adults people aged 65 years who had mild cognitive impairment using the dementia safety center in S city. Among them, telephone interviews were conducted on 9 people, excluding three out of 12 who were dropped out. Results : Meaning and patterns were categorized by four topics in the experience of participating in the woodworking program for the older adults with mild cognitive impairment. First, they restored their confidence and self-esteem with their own works. Second, they gained vitality in their lives through new experiences and memories of carpentry activities. Third, they confirmed their functions and possibilities through the completion of the work. Fourth, they identified their desire for learning and formed social relationships. Conclusion : It was confirmed that the woodworking program had a positive effect on the participation experience of the older adults with mild cognitive impairment. Based on the results of this study, a multidimensional study should be conducted to verify the effectiveness of developing and distributing customized woodworking programs to the older adults with mild cognitive impairment.

노년기 대사증후군, 심폐체력, 인지장애와의 관계

진영윤,김태완,강현식 한국운동생리학회 2022 운동과학 Vol.31 No.4

PURPOSE: This study aimed to examine the independent and combined association of metabolic syndrome (MetS) and cardiorespiratory fitness (CRF) levels with cognitive decline risk in older Korean adults. METHODS: This study included 509 community-dwelling older adults aged 60–89 years (81.7% women). CRF was assessed using the safe and easily administered submaximal exercise 6-min walking test (6MWT) on an outdoor track. Cognitive impairment was assessed using the Korean version of the MMSE for Dementia Screening (MMSE-DS). A multivariate logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for cognitive impairment according to MetS- and CRF-based subgroups. RESULTS: Compared to subjects with no MetS/normal CRF (OR, 1), the risk of cognitive impairment was significantly higher among subjects with MetS/normal CRF (OR, 1.747; 95% CI, 1.044-2.923, p=.043) or no MetS/low CRF (OR, 2.246; 95% CI, 1.146–4.402; p=.018). The OR increased to 3.066 (95% CI, 1.711–5.492; p<.001) for those with both MetS and low CRF. CONCLUSIONS: The early identification and treatment of individuals with MetS or low CRF may significantly reduce the risk of cognitive decline. Furthermore, promoting physical activity may play an important role in preventing MetS and improving CRF among older adults.

The Relationship between Hearing Impairment and Cognitive Function in Middle-Aged and Older Adults:

Soo Jung Lee(이수정) 한국언어청각임상학회 2018 Communication Sciences and Disorders Vol.23 No.2

배경 및 목적: 난청이 인지기능에 미치는 영향을 파악하기 위한 다수의 연구들이 이루어지고 있으나, 그 결과는 비교적 일관적이지 않다. 이에, 본 연구는 메타분석을 통하여 장노년층에서 청력 손실군과 정상 청력을 나타내는 대조군 간 인지능력을 비교한 문헌들을 체계적으로 분석함으로써 장노년층의 난청과 인지기능 간 관련성에 대한 종합적인 결과를 도출하고자 하였다. 방법: 국내외 관련 문헌들을 검토한 후 연구 포함 및 제외기준에 따라 총 11편의 연구를 선정하였다. 무선효과모델(random effect model)을 사용하여 효과크기를 산출하였고, 분석방법은, 첫째, 종합적 인지능력을 분석, 둘째, 인지영역(전반적 인지기능, 집행기능/정보처리속도, 작업기억, 언어, 언어적 기억, 시공간 능력)에 따라 분석, 셋째, 인지과제(청각 기능에 대한 의존도가 높은 과제 및 낮은 과제)에 따라 분석하였다. 결과: 청력 손실군은 정상 청력의 대조군에 비해 인지능력이 저하되는데, 특히, 전반적 인지기능, 집행기능/정보처리속도, 작업기억, 언어, 언어적 기억력에서 저하된 수행력을 보였으며, 시공간 능력에서는 두 집단 간 차이가 나타나지 않았다. 또한, 청력 손실군은 청각 기능에 대한 의존도가 높은 인지과제들뿐만 아니라 낮은 과제들에서도 대조군에 비해 수행력이 저하되었다. 논의 및 결론: 본 연구결과는 장노년층에서의 난청이 인지기능 저하와 관련성이 있음을 시사한다. Objectives: Although many studies have attempted to demonstrate the effect of hearing impairment on cognitive function, findings across studies have been relatively inconsistent. The current study aimed to synthesize the findings of previous cross-sectional studies which compared cognitive performance between middle-aged and older adults with hearing impairment and normal hearing controls. Methods: A systematic literature review was performed using meta-analysis (Comprehensive Meta-Analysis version 3.0). A total of 11 studies meeting the inclusion criteria were included in the current meta-analysis. The effect sizes were obtained by Hedges’ g with a 95% confidence interval using a random effect model. Results: Middle-aged and older adults with hearing impairment showed lower cognitive performance as compared to normal hearing controls, especially in the domains of executive function/processing speed, working memory, language, verbal memory, and general cognition. There was no significant difference in visuospatial ability between groups. Also, regardless of whether cognitive measures primarily rely on auditory function or not, hearing-impaired adults showed lower performance than normal hearing controls. Conclusion: The current meta-analytic findings indicate that hearing impairment is associated with cognitive deficits in middle-aged and older adults.

경도인지장애 노인의 인지능력 개선을 위한 운동중재효과: 메타분석적 접근

은홍범 ( Hong-bum Eun ),백성수 ( Seung-soo Baek ) 한국운동생리학회(구 한국운동과학회) 2021 운동과학 Vol.30 No.1

PURPOSE: Old adults with mild cognitive impairment (MCI) are at high risk for developing dementia. Exercise is a promising intervention for cognitive decline. This study evaluated the effects of exercise interventions on cognitive adaptation for older adults with MCI and attempted to identify which specific modality of exercise is more effective. METHODS: National Assembly library, Research information sharing service, Google scholar databases from 1 January 2010 to 31 Oct 2020 were utilized for searching articles related to research purpose. Meta-analysis was conducted with Comprehensive Meta-Analysis 2.0 using the fixed-effect model for the available data without significant heterogeneity, or the random-effect model was used if appropriate. RESULTS: Through meta-analysis in 13 studies, the combination of aerobic and resistance movements significantly improved cognitive ability and showed that intervention in a particular week and time is of paramount importance to improving cognitive function. CONCLUSIONS: The Combination of aerobic and resistance exercise led to an improvement in cognitive ability and had a positive effect with a middle effect size on cognitive function in older adults with MCI.

지역사회에 거주하는 경도인지장애 노인들을 위한 인지재활프로그램의 효과

최영희(Young Hi Choi),윤가현(Gahyun Youn) 한국노년학연구회 2019 한국 노년학연구 Vol.28 No.1

대다수 고령자들은 나이가 들면 들수록 여러 가지 인지적 과제의 수행능력이 저하된다. 근래에는 평균수명의 연장으로 치매와 같은 병리학적 노화로 인해 인지기능 손상을 입은 고령자들이 지속적으로 늘고 있다. 본고는 지역사회에 거주하는 경도인지장애 노인들을 대상으로 11주일 동안 진행되었던 인지재활프로그램의 효과를 정리한 것이었다. 본 프로그램 실시의 주목적은 참여자들의 치매 위험을 감소시키고 삶의 질을 제고시키고자 하는 것이었고 또 관절범위 운동의 신체적 활동에 초점이 맞추어진 프로그램에는 원예치료나 레크리에이션 치료, 예술치료 등이 가미되어 있었다. 프로그램을 실시한 효과는 인지기능 상태, 우울증상, 삶의 질, 도구적 일상생활동작능력 등을 토대로 검증했는데, 모두 의미 있게 드러났다. 그러나 연구결과를 일반화시킬 수 있는지에 대한 제한점도 있었으며, 이는 표본의 이질성이나 작은 표본 문제 그리고 대조군이 없는 실험설계 문제의 맥락에서 논의했다. Older adults tend to show poorer performance in a variety of cognitive tasks as they get older and older. While increasing life expectancy these days, the number of people suffering from dementia and of those developing dementia due to pathological aging would have been rising. This article was to report the effect of a cognitive rehabilitation program for community-dwelling older adults with mild cognitive impairment which was administered for about 11 weeks. The main purpose of administrating the program to the older adults was to reduce their risk of dementia and to improve their quality of life. Several therapeutical methods such as horticultural therapy, recreation therapy, art therapy and so on were involved in the program which was focusing upon range of motion physical activities. The results of program administration on mini-mental states, depressive symptoms, quality of life, and instrumental activities of daily living were tested and all found significantly. However, some limitations of generalizing the results were discussed in the context of the heterogenous sample, small sample size, and study design with no control group problems.

노인들의 걷기 실천과 경도인지장애의 관련성

김춘종 ( Chun-jong Kim ) 한국특수체육학회 2021 한국특수체육학회지 Vol.29 No.1

이 연구의 목적은 일상생활 속 걷기 실천과 경도인지장애 간의 관련성을 분석하는 것이다. 이러한 연구목적을 달성하기 위해서 2019 지역사회건강조사의 원시자료를 바탕으로 분석하였으며, 연구대상은 만 65세 이상이면서 최근 1년 동안 인지장애 경험이 있는 노인으로 하였다. 자료분석은 SPSS 25.0 프로그램을 이용하여 교차분석과 로지스틱 회귀분석을 실시하였으며, 유의수준은 p<0.05로 설정하였다. 연구결과는 다음과 같다. 첫째, 걷기 실천이 주 3-4일이면서 일일 30-59분, 60-89분, 90분 이상 실천한 각각의 집단과 경도인지장애 간의 관련성은 통계적으로 유의하지 않았다. 둘째, 걷기 실천이 주 5일 이상이면서 일일 30-59분 실천한 집단과 경도인지장애 간의 관련성은 통계적으로 유의하지 않았다. 그러나 걷기 실천이 주 5일 이상이면서 일일 60-89분 참여한 집단은 미참가 집단보다 경도인지장애의 위험성 OR값이 0.548(95% CI=0.381-0.789, p<0.01), 걷기 실천이 주 5일 이상이면서 일일 90분 이상 참여한 집단은 미참가 집단보다 경도인지장애의 위험성 OR값이 0.416(95% CI= 0.261-0.665, p<0.001)로 유의하게 나타났다. 따라서 노인의 경도인지장애 위험을 감소시키기 위해서 주 5일 이상, 일일 60분 이상 걷기 실천을 권장한다. The purpose of this study was to analyze the association between the everyday walking of older adults elderly and mild cognitive impairment. In order to achieve the purpose, the raw data of the 2019 Community Health Survey were analyzed and the subjects were older adults who are over 65 years old have experienced cognitive impairment during the past year. Collected data were analyzed with crosstabulation and logistic regression analysis(p<.05). The results of logistic regression analysis were as follows. first, the association between each group that performed walking 3-4 days a week for 30-59 minutes, 60-89 minutes, or over 90 minutes each day and mild cognitive impairment was not statistically significant. Second, the association between the group that performed walking more than five days a week for 30-59 minutes a day and mild cognitive impairment was not statistically significant. However, the group that performed walking more than five days a week for 60-89 minutes a day showed an OR value of mild cognitive impairment lower than that of the non-walking group by 0.548(95% CI=0.381-0.789, p<0.01) and the group that performed walking more than five days a week for over 90 minutes a day showed an OR value lower by 0.416(95% CI= 0.261-0.665, p<0.001). These results were significant. Therefore, it would be necessary to perform walking more than five days a week for over 60 minutes a day in order to reduce the risk of mild cognitive impairment of older adults.