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Purpose: In this study, we investigated the effects of a cognitive training program on cognitive function, depression, anxiety, and activities of daily living in patients with stroke. Methods: The study included 64 patients with stroke, who were admitted to a hospital in M city between January 2019 and April 2021. Patients were randomly selected and assigned to experimental and control groups (n=32 in each group). The experimental group underwent a cognitive training program in addition to conventional physical therapy, whereas the control group received only conventional physical therapy. The analysis of covariance test revealed significant differences. Results: We observed significant intergroup differences in cognitive function, depression, anxiety, and activities of daily living (P<0.05). Conclusion: Cognitive training combined with conventional physical therapy effectively improved physical and mental functions, promoted functional recovery, and improved quality of life in patients with stroke. The intervention used in this study was a clinically valuable scientific and effective method for treatment of patients with stroke. Future large-scale studies are warranted to establish a more systematic and specific training program to definitively evaluate the effects of cognitive therapy in patients with stroke.

The purpose of this study was to determine whether gaze stability exer-cises would result in improvements of cognitive function, balance ability and subjective health status in old people with and without mild cogni-tive impairment (MCI). Old people with MCI (n=9) and healthy old peo-ple (n=9) performed gaze stability exercises for 4 weeks. Pre and post Montreal Cognitive Assessment (MoCA) for cognitive function, Timed Up and Go test for dynamic postural ability, Activities-Specific Balance Confidence for balance confidence and subjective health status were measured in both groups. After participating in gaze stability exercises, all outcome measures were significantly improved in MCI group and normal group also improved significantly in all outcome measures with the exception of balance confidence. In addition, there were significant differences in cognitive function and balance confidence between the two groups, and more improvements in MCI group. These results pro-vide evidence that gaze stability exercises is beneficial to improve cog-nitive function as well as balance ability which affected on quality of life in old people with and without MCI.

This study examined the association among cognitive function, physical fitness, and health status in healthy older women. Ninety-four females aged from 62 to 86 years (72.66±5.38 years) from community healthcare centers and an exercise club in Seoul, South Korea. Cognitive function was assessed using the Seoul Neuropsychological Screening Battery. Physical performance comprised cardiorespiratory endurance, lower extremity strength, active balance ability, and walking speed. Health status included blood pressure and waist circumference. Multiple lin-ear regression analyses were performed to determine the relationship among cognitive function, fitness components, and health status, with age and educational attainment as covariates. In the unadjusted model, attention was significantly associated with cardiovascular endurance (B=0.19, P<0.05). Memory was significantly associated with lower limb strength (B=0.77, P<0.05) and active balance ability (B=2.35, P<0.05). In the adjusted model, attention was significantly associated with car-diovascular endurance (B=0.15, P<0.05). Memory was significantly as-sociated with lower limb strength (B=0.87, P<0.05). In both models, cognitive function was not significantly associated with any health sta-tus variable. Though limited by a relatively small sample of female par-ticipants, who were healthy registrants of a community exercise pro-gram with normal cognitive function, the current study demonstrates that cognitive function is significantly associated with physical fitness, but not with health status, in healthy older women.

We investigated the effect of exercise rehabilitation based on fine mo-tor movement for the elderly with mild dementia. Using electroenceph-alogram (EEG), the change of brain wave of them based on fine motor movement and comparing the improvement level of cognitive ability and performance capability in daily living activity was recorded. The subjects were the elderly with mild dementia living in a sanatorium in Incheon city. Mini-Mental Status Examination, activity of daily living (ADL), and the influence on depression were examined. After 8-week exercise program, significant difference in cognitive function and ADL was observed, however, and there was no significant difference in de-pression. In the EEG, there was a significant difference in α-wave. This study suggests the chance to remind the necessity of exercise programs for improving cognitive function and ADL of the elderly with dementia.

Aging is associated with a progressive decline in both cognitive and physical function, and neuroinflammation and metabolic dysregulation often exacerbate this decline, particularly in older women. This study investigated the effects of a 12-week intermittent combined exercise program on cognitive function, physical performance, and neurophysi-ological biomarkers in community-dwelling women aged 75 years and older. Forty participants were recruited from a local welfare center and randomly assigned to an exercise group (n=20) or a control group (n=20). The exercise group participated in three supervised sessions per week that integrated aerobic exercise, resistance exercise, func-tional exercise, and cognitive exercise. Cognitive domains (attention, language, and memory) were assessed using the Seoul Neuropsycho-logical Screening Test-II. Physical function was assessed using the Geriatric Physical Fitness Test (chair stand, arm flexion, grip strength, and 6-min walk). Blood samples were analyzed to measure serum brain-derived neurotrophic factor (BDNF), interleukin (IL-6), tumor ne-crosis factor (TNF)-α, high-density lipoprotein cholesterol (HDL-C), low- density lipoprotein cholesterol (LDL-C), and triglycerides (TG). Paired and independent t-tests were performed to evaluate pre- and posttest differences (α=0.05). After 12 weeks, the exercise group significantly improved memory (P<0.05), lower upper-body muscle strength, grip strength, and walking endurance. Serum BDNF significantly increased (P<0.01), and IL-6, TNF-α, LDL-C, and TG decreased (P<0.05). HDL-C levels also significantly increased (P<0.05). Intermittent combined ex-ercise significantly improved cognitive and physical function and favor-ably modulated neurotrophic, inflammatory, and metabolic biomarkers in very elderly women.

Aging is accompanied by progressive impairments in mitochondrial bioenergetics, apoptosis regulation, and gut microbiota homeostasis, all of which contribute to cognitive decline. In this study, we investigat-ed whether the effects of treadmill exercise on the gut microbiota-mito-chondrion-neuronal plasticity axis differed between young (15 months) and old (28 months) mice. Male C57BL/6 mice were randomly assigned to the following groups: early sedentary, early exercise, late sedentary, or late exercise groups and completed an 8-week treadmill training protocol. Cognitive function was assessed using the passive avoidance test and the Morris water maze test. Hippocampal mitochondrial respi-ration, Ca²⁺ retention capacity, and Bax/Bcl-2 expression were quanti-fied, and the gut microbiota composition was analyzed using 16S ribo-somal RNA sequencing. Mice that did not exercise in old age exhibited memory impairment, decreased mitochondrial oxidative respiration, re-duced Ca²⁺ retention, increased Bax expression, decreased Bcl-2 lev-els, and decreased abundance of Lactobacillus, Bifidobacterium, and Akkermansia. Exercise significantly improved behavioral performance, mitochondrial function, and apoptosis balance, while also increasing beneficial gut microbiota. Notably, these effects were significantly greater in late-aged compared to early-aged mice. These results demonstrate that the efficacy of exercise in modulating the microbio-ta-mitochondrion-brain axis varies with age. Early-aged appears to rep-resent a more responsive biological period during which exercise is more effective in improving mitochondrial integrity, microbiota compo-sition, and cognitive resilience. These results suggest that initiating ex-ercise early in the aging process may maximize neuroprotective effects and delay age-related functional decline.

The apolipoprotein E (APOE) gene has been suggested to be associated with stroke and dementia. However, the effects of exercise training on dementia according to the APOE genotype are not consistent to those reported by previous studies. Therefore, we examined the effects of ex-ercise training on stroke risk factors including blood pressure, lipid pro-files, homocysteine (Hcy) concentrations, and cognitive function ac-cording to the APOE genotype in stroke patients. We examined the stroke risk factors, Hcy, and cognitive function in 28 ischemic stroke pa-tients before and after 6 months of exercise training. After exercise training, body weight, body mass index (BMI), and percent body fat de-creased significantly in both APOE groups. According to the APOE gen-otype, the changes in BMI in the APOE ε4 group higher than those in APOE ε3 group significantly. Total cholesterol (TC), low-density lipopro-tein (LDL)-C, triglyceride (TG), and Hcy decreased and high-density lipo-protein (HDL)-C increased significantly in the both groups. According to the APOE genotype, systolic blood pressure in the APOE ε4 group de-creased, but in the APOE ε3 group increased after exercise training. TC, LDL-C, and TG in the APOE ε4 group decreased more extensively than those in the APOE ε3 group after exercise training. VO2max (maximal oxy-gen consumption) and cognition increased significantly in both groups. Folate acid intake also increased significantly in both groups. The APOE genotype affects variations in the risk factors of stroke after exercise training. However, the Hcy and cognitive function did not differ based on the APOE genotype.

This study conducted the Korean version of Mini-Mental State Exam-ination (MMSE-K) to women aged 65 or older residing in Gangwon-do Province and screened those who were suspicious to have mild de-mentia for receiving 23 points or lower in it. For eight weeks, this author tried to verify the effects of whole body vibration exercise intervention on electroencephalogram (EEG) activation and cognitive function in women with senile dementia. According to the results, both EEG activa-tion and cognitive function indicated statistically significant difference in terms of the interactive effect between the measuring times and groups, and there was statistically significant improvement found after the whole body vibration exercise intervention. The results of this study are meaningful because they present the possibility of whole body vi-bration exercise intervention to be integrated into the plan to improve life quality in patients with senile dementia by stimulating their muscle spindles and sensory organs only with the amplitude and the number of vibrations with no burden of physical activity and enhancing their EEG activation and cognitive function through the responses of the neuro-muscular system.

본 연구는 밸런스 운동이 인지기능 경계 노인의 인지기능(MMSE-DS), 기능적 체력(상·하지 근력 및 평형성), 뇌 파의 고유리듬 주파수(Peak Frequency, PF), 및 뇌파 주파수대역(알파파, 세타파) 변화에 미치는 영향을 분석하였다. 연구대상자는 MMSE-DS 점수가 20~26점에 해당하는 65세 이상 노인 40명으로 구성되었으며, 이들을 밸런스 운동에 참여한 실험집단과 일상생활을 유지한 통제집단으로 무작위 배정하여 8주간 중재를 실시하였다. 연구 결과, 실험집단에 서는 MMSE-DS 점수가 유의하게 증가한 반면(p<.000), 통제집단에서는 유의한 감소가 나타났다. 또한, 실험집단은 하 지 근력과 평형성에서도 유의한 향상이 있었으나(p<.05), 통제집단에서는 유의한 변화가 없었다. 뇌파 분석 결과, 실험집 단에서는 전전두엽과 전두엽(Fp1, Fp2, F3, F4), 그리고 좌측 측두엽(T3)에서 고유리듬 주파수(PF)가 유의하게 증가하 였다(p<.001). 더불어, 알파파 활성도는 증가하고 세타파는 감소하는 경향을 보였다. 이는 밸런스 운동이 전전두엽과 측두엽의 기능을 활성화시켜 인지기능 개선에 기여할 수 있음을 시사한다. 이러한 결과는 밸런스 운동이 인지기능 유지 및 향상에 긍정적인 영향을 줄 수 있으며, 인지기능 훈련 프로그램 개발에 기초자료로 활용될 수 있음을 나타낸다.

This study analyzed the effects of balance exercise on cognitive function (MMSE-DS), functional fitness (upper and lower limb strength and balance), peak frequency (PF) of brain waves, and changes in brainwave frequency bands(alpha and theta waves) in elderly individuals with borderline cognitive function. The study participants included 40 older adults aged 65 years or older with MMSE-DS scores ranging from 20 to 26. They were randomly assigned to either an experimental group (participating in balance exercises) or a control group (maintaining daily activities) for an 8-week intervention. The results showed a significant increase in MMSE-DS scores in the experimental group (p<.000), while a significant decrease was observed in the control group. Additionally, lower limb strength and balance significantly improved in the experimental group (p<.05), whereas no significant changes were observed in the control group. EEG analysis revealed a significant increase in peak frequency (PF) in the prefrontal and frontal lobes (Fp1, Fp2, F3, F4) as well as the left temporal lobe (T3) in the experimental group (p<.001). Moreover, alpha wave activity increased, while theta wave activity showed a decreasing trend. These findings suggest that balance exercise may contribute to cognitive function improvement by enhancing activity in the prefrontal and temporal lobes. These results indicate that balance exercise can positively influence the maintenance and improvement of cognitive function and may serve as a foundational reference for the development of cognitive training programs.

목적 : 본 연구는 임상적 활용을 위하여 LOTCA-G 번역판을 사용하여 도시지역 노인의 인지기능을 알아보고, LOTCA-G 한국판 개발을 위한 기초자료를 확보하고자 시행되었다. 연구방법 : 연구대상자는 대전광역시에 거주하는 뇌손상의 경험이 없거나 치매로 진단받지 않은 65세 이상의 노인 117명이었으며 직접 면접조사 및 LOTCA-G를 사용한 인지기능평가를 통해 자료를 수집하였다. 자료 수집 기간은 2005년 3월 11일에서 4월 2일까지로 23일간 실시되었다. 결과 : 1. 연구대상자들의 LOTCA-G를 이용한 인지기능 검사 점수는 총점 104점에 평균 92.17±10.66점이었으며, 연령이 낮은 군일수록, 교육수준이 높은 군일수록 인지기능점수가 통계적으로 유의하게 높았다.2. LOTCA-G의 각 하위영역별 평가 점수는 교육수준이 높은 군인 경우에 대부분의 영역에서 유의하게 높았고, 연령이 높은 군일수록 각 영역 별로 점수가 통계적으로 유의하게 낮아졌다.3. LOTCA-G의 각 하위영역 간 관계는 실행력과 주의력/집중력을 제외하고는 모든 영역 간에 유의한 상관관계를 보였다.4. MMSE-K와 LOTCA-G의 총점수를 비교했을 때 유의한 높은 상관관계를 가짐을 알 수 있었으며, MMSE-K의 분류별 점수에 따른 LOTCA-G의 점수는 24점 이상(96.35±5.52), 23-18점(87.72±5.52), 17점(55.40±16.56)으로 각 각 유의한 차이가 있었다. 결론 : LOTCA-G를 사용한 도시지역 노인의 인지기능수준은 연령, 교육기간에 따라 차이가 있었다. 간이신경검사인 MMSE-K와 비교하였을 때 LOTCA-G는 유의미한 상관관계를 가지고 있어 연구에서 사용된 한국어로 번안된 본 도구도 인지기능을 평가하는 데 타당함을 알 수 있었다. 그러나 외국에서 개발된 LOTCA-G를 그대로 번안 하여 사용한 것이므로 문화적, 사회적 차이로 인한 문항 간 차이점이 존재하는 것으로 사료된다. 후속 연구에서는 이러한 점을 수정 및 보완하여 한국판 LOTCA-G를 개발하는 것이 필요하겠다.

Objective : The purpose of this study was to investigate the cognitive function of elderlies in urban areas, and to use the result for the basic data for Korean version LOTCA-G’s later development. Methods : The subjects of this study was total 117 elderlies dwelled in Daejon city and aged over 65 who doesn’t have any record of having brain damage or dementia. During 23 days which was from March 11th, 2005 to April 2nd, 2006, Subjects were interviewed and evaluated on Loewenstein Occupational Therapy Cognitive Assessment for geriatric population(LOTCA-G). Results : 1. The average scores for LOTCA-G of the elderlies were 92.17±10.66 out of total score 104. The scores were higher for younger person than older person, and a person who had a higher education level.2. The scores for each sub test of LOTCA-G were significantly got lower for older and lower education level group.3. Each sub test of LOTCA-G was significantly correlated in the most of the subtest except for the performance and attentiveness/concentration.4. When comparing Mini-Mmental State Examination test - Korean Version(MMSE-K) with LOTCA-G’s scored, they showed significant correlations. And according to classification on the MMSE-K’s scores, the scores of LOTCA-G were 96.35±5.52(over 24), 87.72±5.52(23-18), and 55.40±16.56(below 17). LOTCA-G’s scores for each classification had significant diffferences. Conclusion : Using LOTCA-G, elderlies in urban areas’ cognitive function levels had differences in age and education level. Comparing to the MMSE-K, LOTCA-G had significant correlations, so this showed that LOTCA-G adapted into Koreans used in study had validity in evaluating cognitive function.However, considering the differences in psychomeric evaluation scores which affected by culture and society, it is required to develop korean version LOTCA-G by modifying it and adding complements in later study.

목적: 본 연구는 인지가 건강한 지역사회 중고령자 인구를 대상으로 한 인지적 여가활동 중재연구를 분석하여 국내 지역사회 적용을 위한 근거를 마련하고자 한다. 연구방법: 본 연구에서는 2013년 1월부터 2023년 12월까지 최근 10년간 국외 학술지에 게재된 문헌을 대상으로 PRISMA 지침에 따라 문헌고찰을 진행하였다. PubMed, EMBASE, Web of Science, CINAHL, APA PsycInfo 데이터베이스를 사용하였으며, 주요 검색어로 (“elderly” OR “older*”) AND (“leisure*” OR “leisure activities”) AND (“cognitive*”AND “dementia”)를 사용하였다. 대조군이 있는 실험연구를 선정하였으며, Physiotherapy Evidence Database (PEDro) scale을 통해 선정된 문헌의 질을 평가하였다. 결과: 최종 6편의 연구 분석결과, 인지적 여가활동 중재는 악기 연주, 독서, 보드게임, 직소 퍼즐의 네 가지 범주로 구분되었으며, 악기 연주와 보드게임 중재가 각 2편으로 가장 많았다. 직소 퍼즐을 제외한 중재에서 실험군은 대조군에 비해 인지기능에서 유의한 향상을 보였으며, 이는 음운언어 및 범주언어 유창성, 언어 및 시각 작업기억, 집행기능과 억제조절, 분리주의력, 시각적 스캐닝, 전반적인 인지기능 개선을 포함한다. 또한, 여가활동 수행기술, 기분상태, 신체적 및 심리적 건강 영역에서의 삶의 질의 개선 효과도 관찰되었다. 결론: 본 연구는 일부 인지적 여가활동 중재가 지역사회 중고령층부터 고령층에 이르는 지역사회 인구의 인지기능 및 심리사회적 영역에 긍정적인 영향을 줄 수 있음을 확인하였다. 향후 작업치료 분야에서 인지 건강 강화를 위해 다양한 인지적 여가활동이 일상생활의 일부로서 적극적으로 활용되기를 기대한다.

Objective: This study analyzed cognitive leisure activity intervention studies in cognitively healthy middle-aged and older adult populations and establishes a foundation for application within the domestic community. Methods: We conducted a systematic review following the PRISMA guidelines, focusing on academic journals from January 2013 to December 2023. We searched PubMed, EMBASE, Web of Science, CINAHL, and APA PsycInfo databases using the terms “elderly” or “older*”, “leisure*” or “leisure activities,” “cognitive*”, and “dementia.” We selected experimental studies with control groups and assessed their quality using the PEDro scale. Results: Six studies analyzed cognitive function interventions through leisure activities grouped into four categories: playing musical instruments, reading, board games, and jigsaw puzzles. Excluding jigsaw puzzles, the experimental group exhibited significant cognitive function improvements, including enhancements in phonological and category verbal fluency, verbal and visual working memory, executive function, inhibitory control, divided attention, visual scanning, and overall cognitive function, compared with the control group. Improvements were also observed in performance, mood, and quality of life. Conclusion: This study found that cognitive leisure activities can improve cognitive function and psychosocial domains in community populations including middle-aged and older adults. These activities can be incorporated into daily life to promote cognitive health during occupational therapy.

목적 : 본 연구의 목적은 컴퓨터 기반 전산화 인지 훈련이 정신분열증 환자의 인지기능과 수단적 일상생활 활동에 미치 는 영향을 알아보는 것이었다. 연구방법 : 연구 설계는 사전사후(pre-test and post-test design)이며 종속변인으로 집중력, 기억력, 실행기능과 수단 적 일상생활활동 수준을 독립변인으로 컴퓨터 기반 전산화 인지훈련(REHACOM)을 사용하였다. 연구 대상자는 12명 이었으며, 인지훈련을 위한 중재 프로그램은 레하컴의 집중력, 기억력, 실행기능 훈련 프로그램을 주 2회씩 8주간 총 16회기 동안 실시하였다. 결과 : 연구결과 집중력, 기억력, 실행기능, 수단적 일상생활 수행능력에서 유의미한 향상을 보였고(p<.05), 기억력과 수 단적 일상생활 활동이 유의한 상관관계를 나타냈다(p<.05). 결론 : 본 연구 결과 전산화 인지훈련은 정신분열증 환자의 인지기능과 수단적 일상생활 수행능력에 긍정적 영향을 미쳤 다. 추후 연구에서는 대조군을 통한 비교 연구와 다양한 인지훈련 프로그램을 적용한 인지 영역별 연구가 이루어져야 할 것이다.

Objective : The purpose of this research was to investigate the effects of computer-based cognitive training on the cognitive function and instrumental activities of daily living in people with schizophrenia. Methods : The design of this research including a pre-test and a post-test study. For this study, the concentration, memory, executive function, and level of instrumental activities of daily living were used as dependent variables, and computer-based cognitive training (REHACOM) was used as an independent variable. Twelve subjects participated in the study. As an intervention, the concentration, memory, and executive function training program of REHACOM was conducted twice per week during and an eight-week period, 16 times in total. Results : As a result of the study, the patients demonstrated significant improvements in their concentration, memory, executive function, and instrumental activities of daily living (p<.05). Additionally, there was a significant correlation between memory and instrumental activities of daily living (p<.05). Conclusions : This study demonstrated that a computer-based cognitive training program is effective not only on the cognitive function, but also on the instrumental activities of daily living, in people with schizophrenia. As a future study, investigators need to consider research using a control group and a specialized cognitive training program applying various cognitive functions.

본 연구의 목적은 폐경 후 여성에게 8주간 필라테스를 적용하고 인지 기능, 신체 기능 및 폐경 증상을 검증하는 데 있다. 연구는 무작위 대조 연구로 설계하였으며, 8주간 필라테스를 적용한 필라테스 그룹(Pilates group, PG, n=14) 과 걷기 그룹(Walking group, WG, n=14)으로 무작위 할당하였다. 중재는 주 3일 8주 동안 시행하였다. PG의 중재 프로 그램은 2단계 강도로 구분된 필라테스 60분 동안 적용하였으며, WG의 중재 프로그램은 목표심박수의 50~60%로 설정된 걷기로 구성되었다. 중재에 대한 평가는 먼저 인지 기능 평가로 기호잇기검사(TMT) A와 B, 그리고 한국판 인지장애 선별 검사(K-CIST)를 시행하였으며, 신체 기능은 Berg Balance Scale(BBS)을 사용한 균형 및 슬관절 신전과 굴곡 근력을 평가하였다. 폐경 증상은 폐경 삶의 질(MENQOL) 설문지를 통해 평가하였다. 연구 결과는 두 집단 모두 모든 인지 기능 변인이 중재 후 개선되었으며, PG가 더 우수한 것을 확인하였다. 신체 기능적 변인은 균형은 두 집단 모두 개선되었으며, PG가 더 우수하였고, 슬관절 신전 및 굴곡 근력은 PG만 개선되었다. 폐경 증상은 두 집단 모두 유의하게 개선되었다. 따라서, 필라테스가 인지 기능과 신체 기능 모두에서 걷기보다 더 효과적이며, 신체적 자극과 함께 인지적 자극을 제공하 여 더 포괄적인 건강 증진을 끌어낼 수 있음을 본 연구를 통해 제안할 수 있다.

The purpose of this study was to evaluate the effects of Pilates for 8 weeks on cognitive function, physical function, and menopausal symptoms in postmenopausal women. The study was designed as a randomized controlled trial, with participants randomly assigned to a Pilates group (PG, n=14) and a walking group (WG, n=14) for 8 weeks of Pilates. The intervention was implemented three days a week for eight weeks, with the PG intervention program consisting of 60 minutes of Pilates divided into two levels of intensity, and the WG intervention program consisting of walking at 50-60% of target heart rate. The interventions were evaluated using the Trail Making Test (TMT) A and B and the Korean version of the Cognitive Impairment Screening Test (K-CIST) to assess cognitive function, and the Berg Balance Scale (BBS) to assess balance and knee extension and flexion strength. Menopausal symptoms were assessed using the Menopause Specific Quality of Life (MENQOL) questionnaire. The results showed that all cognitive function variables improved post-intervention in both groups, with PG showing greater improvement. In terms of physical functioning variables, balance improved in both groups, but better in PG, and knee extension and flexion strength improved in PG only. Menopausal symptoms were significantly improved in both groups. Therefore, it can be suggested from this study that Pilates is more effective than walking in both cognitive and physical function, and that it can provide cognitive stimulation along with physical stimulation, leading to a more comprehensive health improvement.

본 연구는 국내 경도인지장애 환자의 인지기능을 위한 이중과제 프로그램의 효과를 분석하기 위해 체계적 문헌고찰 및 메타분석을 시행하였다. 8개의 데이터베이스를 사용하여 검색하였으며, 검색어는 경도인지장애, 인지, 이중과제였다. 2013년 1월부터 2023년 7월까지 출간된 문헌 중 무작위 및 비무작위 대조군 실험설계를 분석하였다. 총 682편의 문헌이 검 색되어 포함 및 배제 기준을 충족한 8편의 문헌을 최종 분석하였다. 문헌의 질 평가는 RoB와 RoBANS를 사용하였다. 메타분 석은 CMA 4.0 ver.을 사용하였다. 분석 결과 이중과제 프로그램의 전체 효과 크기는 중간 효과 크기였다. 결과변수에 따른 효과 크기는 지남력, 실행기능은 큰 효과 크기이며, 전반적 인지기능, 시공간기능, 기억기능, 주의기능은 중간 효과 크기였다. 중재 기간에 따른 분석 결과 적용 기간은 4~8주 적용이 효과가 더 크게 나타났으며, 총 회기에서는 24~30회기 적용의 효과 크기가 더 크게 나타났다. 본 연구는 경도인지장애 환자의 인지기능 증진을 위해 적용된 이중과제 프로그램의 효과 및 적용 방법에 대한 임상적 근거를 제시하였다.

This study conducted systematic review and meta-analysis to analyze the effectiveness of a dual-task for cognitive function in patients with MCI in Korea. A search was conducted using eight databases, and the search terms were MCI, cognition, and dual task. This study includes RCT and nonRCT published from January 2013 to July 2023. A total of 682 studies were searched, and 8 studies that fulfilled the inclusion and exclusion criteria were finally analyzed. Methodological quality was assessed with the RoB, RoBANS. The meta-analysis used CMA 4.0 ver. As a result of the analysis, the overall effect size of the dual task was medium effect size. The effect size according to the outcome variables was large for orientation and executive function, and medium effect size for global cognitive function, visuospatial function, memory, and attention. As a result of analysis according to the intervention period, the effect was greater when applied for 4 to 8 weeks, and the effect size was larger when applied for 24 to 30 sessions. This study presented clinical evidence on the effectiveness and application method of a dual-task applied to improve cognitive function in patients with MCI.

목적 : 본 연구는 체계적 고찰을 통해 노인의 인지 기능 향상을 위한 전산화 인지 훈련이 어떠한 효과가 있는지 분석하고자 한다. 연구방법 : 2006년부터 2016년까지의 10년 간의 문헌을 Medline, EMbase, Cochrane, CINAHL, PsycINFO, KISS, KMbase, NDSL 데이터베이스에서 검색하였다. 검색 키워드로는 ‘Therapy, Computer-Assisted (Mesh term)’, ‘Aged (Mesh term)’, ‘Cognitive Therapy (Mesh term)’, ‘Randomized Controlled Trial (Publication Type)’, ‘노인’,‘전산화 인지’를 사용하였다. 최종적으로 포함기준에 적합한 8편의 무작위 임상실험설계 연구를 선정하였다. 결과 : 포함된 연구에 대한 방법론의 질적 수준(PEDro 척도)은 6~8점인 ‘좋음’수준에 모두 속하였다. 노인 참여자의 유형으로는 경도인지손상이 45.5%, 정상 노인 27.3%를 차지하였다. 측정한 종속변수는 기억력이 31.6%, 전반적 인지 기능이 21.0%, 주의집중력과 실행 기능이 각각 15.8%를 차지하였다. 경도인지장애 노인을 대상으로 한 5편의 연구 중 4편에서 기억력에 긍정적 효과를 보였고, 주의집중력을 종속변수로 측정한 3편의 연구에서 유의한 향상을 보였다. 정상 노인을 대상으로 한 3편의 연구에서는 기억력이 향상되었다. 결론 : 이번 연구를 통하여 전산화 인지 훈련이 노인의 인지 기능에 미치는 효과를 알 수 있었다. 이는 작업치료사에게 임상적 근거를 제공하고자 하였으며, 추후에는 본 연구 결과를 바탕으로 노인의 장기적으로 인지 기능을 관리하는 방법에 대한 임상적 근거 마련에 대한 연구가 진행되어야 한다.

Objective : The aim of this study is to investigate the effect of Computer-Assisted Cognitive Training(CACT) applied for improving cognitive function among older adults. Methods : Previous studies were found in an electronic database(e.g., Medline, EMbase, Cochrane, CINAHL, PsycINFO, KISS, KMbase, NDSL) between 2006 and 2016 for 10 years. The following key terms were used: ‘Therapy, Computer-Assisted (Mesh term)’, ‘Aged (Mesh term)’, ‘Cognitive Therapy (Mesh term)’, ‘Randomized Controlled Trial (Publication Type)’. Finally, 8 RCT articles met the inclusion criteria. Results : PEDro score in all the articles reviewed was from 6 to 8 points in the‘Good’ range. Types of client group in older adult included 45.5% Mild Cognitive Impairment(MCI), 27.3% healthy older adult. Dependent valuables included 31.6% Memory, 21.0% Global cognitive function, 15.8% Attention and Executive function each. In MCI, Memory showed a positive effect in 4 out of 5 articles, and Attention was significantly improved in 3 articles measured attention as the dependent variable. 3 articles for healthy older adult showed a significant improvement on Memory. Conclusion : Through this systematic review, we were able to understand effect of CACT for cognitive function in older adults. It was to provide clinical evidence to the occupational therapist and research on long-term intervention may be further developed for aging population to make clinical evidence based on these research results.

목적 : 본 연구는 이중과제를 이용한 작업치료 프로그램을 적용하여 경도인지장애 노인의 인지기능 및 보 행에 미치는 효과를 알아보고자 하였다. 연구방법 : 연구 대상은 경도인지장애 노인 36명(실험군 18명, 대조군 18명)이었고, 연구 설계는 사전- 사후 통제 집단설계(pretest-posttest control group design)를 적용하였다. 중재는 주 1회 60분씩, 12주, 총 12회기를 실시하였다. 중재 전과 후의 비교를 위해 인지기능은 노인용 로웬스타인 작업치료 인지평가(Loewenstein Occupational Therapy Cognitive Assessment-Geriatric Population; LOTCA-G) 를, 보행은 일어서서 걷기 검사(Timed Up and Go; TUG)를 사용하였다. 결과 : 이중과제를 이용한 작업치료 프로그램은 실험군의 인지기능과 보행을 향상시켰고 단일과제활동 프 로그램에 참여한 대조군과 유의한 차이를 보였다. 결론 : 본 연구의 이중과제를 이용한 작업치료 프로그램은 경도인지장애 노인의 인지기능 및 보행을 향상 시키는 프로그램으로서의 가치 및 효용성을 확인하였기에, 경도인지장애 노인의 치매예방을 위한 적극적 인 중재 프로그램으로 제안한다.

Objective: The purpose of this study was to investigate the effects of an occupational therapy program using dual-tasks on the cognitive function and gait for the elderly with Mild Cognitive Impairment (MCI). Methods: The subjects were 36 elderly persons with MCI (18 for the experimental group and 18 for the control group). The research design was applied to the pretest-posttest control group design. The intervention was conducted once a week for 60 min during a 12 week period for a total of 12 sessions. For comparison of before and after the intervention, Loewenstein Occupational Therapy Cognitive Assessment-Geriatric Population was used for the cognitive function, and Timed Up and Go was used for the gait. Results: The occupational therapy program using dual-tasks improved the cognitive function and gait of the experimental group and showed a significant difference from the control group. Conclusion: Because the value and efficacy of the occupational therapy program using dual-tasks applied in the present study were confirmed to improve the cognitive function and gait of the elderly with MCI, this study suggests implementing such an approach as an active intervention program to prevent dementia in these individuals.

이 연구는 치매노인의 인지기능 퇴행방지와 잔존신체기능 유지를 위하여 홀니스프로그램을 개발하 고 그 효과를 검증하였다. 연구대상자는 A1 노인복지관 주간보호시설 치매노인 20명을 실험군으로, A2노인복지관 주간보호시설 치매노인 20명을 통제군으로 배치하였으며, 주 1회, 60분간 총 30주에 걸 쳐 홀니스프로그램을 실시하였다. 그 결과, 실험군에서 인지기능(LOTCA-G)을 제외하고 K-MMSE (한국판 간이 정신상태검사), 인지장애정도(GDS), 기능체력(SFT & BBS), 일상생활수행능력(K-ADL) 모두 유의한 차이가 있었고, 실험군의 대응 비교에서도 유의한 차이가 있어 홀니스프로그램이 치매노인 의 인지·신체 통합건강프로그램임을 확인할 수 있었다. 이는 시의성과 학문적 맥락에서 부족한 선행연 구 보완은 물론 관련 지식을 한 층 더 공고히 할 것으로 기대한다.

This study developed a Wholeness program and verified its effectiveness at preventing cognitive degeneration and maintain residual body function of the elderly with dementia. The subjects of this study were A1 Elderly Welfare Center Day Care Center, the 20 elderly with dementia as an experimental group, and A2 Elderly Welfare Center Day Care Facility, the 20 dementia elderly as an control group. A Wholeness program was conducted once a week for a total of 30 weeks for 60 minutes. As a result, in the experimental group, except for cognitive function (LOTCA-G), K-MMSE (Korean version of Mini-mental state examination), cognitive impairment (GDS), functional fitness (SFT & BBS), and daily living ability (K-ADL), there was a significant difference in all of them, and there was a significant difference in the comparison of the correspondence of the experimental group, confirming that the Wholeness program was an integrated cognitive and physical health program for the elderly with dementia. This result confirmed that the Wholeness program was an integrated cognitive and physical health program for the elderly with dementia. It is expected that the results of previous studies that were lacking in timeliness and academic context will be supplemented.

본 연구는 낮 병동 입원 치매 환자를 대상으로 작업치료 융복합활동프로그램을 실시하여, 치매환자의 손 기능, 인지기능, 수단적일상생활활동에 미치는 영향에 대해 알아보았다. 치매환자 34명을 대상으로 작업치료 융복합활동프로그 램과 약물을 동시에 실시한 실험군 17명과 약물치료만 한 17명을 대조군으로 하여 24주간 주 8회 192회기로 실시하였다. 중재 전과 후의 손기능을 알아보기 위해 손의 장악력 검사를 실시하였고, 인지기능을 알아보기 위해 MMSE-K와 GDS를 실시하였다. 또한 수단적일상생활활동을 알아보기 위해 K-IADL를 이용하였다. 중재 결과 실험군에서는 손기능, 인지기능 및 수단적 일상생활활동이 유의하게 증진했지만, 약물치료만 한 대조군에서는 손기능, 인지기능, 수단적 일상생활활동의 증진이 보이지 않았다. 따라서 본 연구 결과 작업치료 융복합활동프로그램은 손기능, 인지기능, 수단적일상생활활동에 긍 정적인 영향을 미친다는 것을 알 수 있다.

This study developed a occupational therapy convergent activity program to provide dementia patients admitted to the daytime ward, and investigated the program’s effect on the hand and cognitive functions and instrumental activities of daily living. A total of 34 dementia patients were divided into two groups: a convergent occupational therapy program and medication were provided for 17 patients, and medication alone was provided for a control group of 17. The intervention was performed for 24 weeks, 8 times per week, 192 times in total. A handgrip strength test was performed to examine hand function before and after the intervention, and the MMSE-K and GDS were performed to evaluate cognitive function. In addition, the K-IADL was used to assess instrumental activities of daily living. With intervention, the experimental group showed significant improvements in hand and cognitive function and instrumental activities of daily living. In contrast, the control group did not show improvements in hand and cognitive function or instrumental activities of daily living. In conclusion, the study showed that a convergent/integrated activity program for occupational therapy has a positive effect on hand and cognitive function as well as instrumental activities of daily living.

본 연구는 65세 이상 노인 148명을 대상으로 하여 사회인구학적요인과 운동참여 유무에 따른 인지기능과 우울, 삶의 질의 차이에 대하여 살펴보았다. 인지기능은 한국판 간이정신상태검사, 숫자 외우기 검사, 선추적 검사, 스트룹 검사를 측정하였고, 심리학적 변인으로는 우울과 삶의 질을 측정하였다. 그 결과 첫째, 노인의 사회인구학적 특성인 연령, 학력, 건강인지에 따라 통계적으로 유의한 차이가 나타났다. 둘째, 운동참여에 따라서는 운동에 참여한 노인이 그렇지 않은 노인에 비해 점수가 높은 것으로 나타났다. 셋째, 운동에 참여하는 노인들의 운동경력, 운동빈 도, 운동시간에 따라 유의한 차이가 나타났다. 마지막으로 연구대상자의 인지기능과 우울 및 삶의 질은 상관관계가 있는 것으로 나타났다. 결론적으로 노인들의 풍요로운 노후를 영위하기 위해 노인의 인지기능을 향상시키고 우울을 감소시켜 삶의 질을 높이기 위한 방법으로 규칙적이고 다양한 운동 및 신체활동 프로그램 참여의 필요성이 있다.

The purpose of this study was to examine the difference of cognitive function, depression, and quality of life according to demographic factors and exercise participation among 148 elderly over 60 years old. The cognitive function was measured by the Korean version of mini mental state exam, Digit span test, Trail making test, and the Stroop test. Also the psychological variables were showed depression and quality of life. As a results, first, depending on the degree of demographic characteristics of elderly had significant difference. Second, according to the participation of the exercise, the score was higher than the aged who did not participate in the exercise. Third, there were significant differences according to duration of exercise, period of exercise, frequency of exercise, and exercise time of the aged that who participate in exercise. Lastly, the cognitive function, depression and quality of life of the subjects were found to be correlated. In conclusion, the aged need to regularly participate in various exercise and physical activity programs to improve the quality of life by improving the cognitive function and decreasing depression of the elderly.

급성기 뇌졸중 환자의 인지기능 저하는 최대 80%까지 발생하는 빈번한 장애로 뇌졸중 후 예후에 중요한 영향을 미치는 종합적인 사고능력이다. 본 연구에서는 급성기 뇌졸중 환자의 인지기능 영향요인으로 산화스트레스 지표인 소변내 8-OHdG와 혈중 MDA 농도를 비교 분석하였다. 본 연구에서 최초 증상 발현 3일 이내의 급성기 뇌졸중 대상자의 40.1%(274명)이 인지기능 저하로 나타났고 소변내 8-OHdG와 혈중 MDA 농도가 인지기능 정상 군과 유의한 차이를 보였다. 또한 산화스트레스 상태의 소변내 8-OHdG와 혈중 MDA 농도는 인지기능 저하를 유 의하게 높이는 것으로 나타났다(p<.005). 급성기 뇌졸중 환자의 인지기능 저하는 질병의 장단기 예후와 주요하게 연관되어 조기에 중재되어야 하므로 인체내 산화스트레스 관련된 객관적인 생체지표를 고려하는 것이 필요하다.

Cognitive impairment occurs frequently up to 80% in the patients with stroke and that has an important influence on the prognosis after stroke. In this study, 8-OHdG in urine and MDA concentration in blood were compared and analyzed as factors influencing cognitive function in acute stroke patients. 274 (40.1%) of all subjects of acute stroke showed cognitive decline, and 8-OHdG in urine and MDA concentration in blood showed a significant difference with normal cognitive function group. In addition, 8-OHdG and blood MDA concentrations in urine in oxidative stress were found to significantly increase cognitive impairments (p<.005). Cognitive impairment in acute stroke patients is mainly related to the short- and long-term prognosis of the disease and must be intervention early, so it is necessary to consider objective biomarkers related to oxidative stress in the patients