Earticle

Background: Numerous studies have consistently demonstrated that depression can be associated with cognitive function decline, primarily focusing on older adults due to the neurodegenerative characteristics of dementia. With persistent depression frequently reported in patients with early-onset or young-onset dementia, this study aimed to assess the impact of depression, specifically the changes in depressive symptoms over time, on the risk of cognitive function decline in middle-aged adults in Korea. Methods: This retrospective study utilized data from the first four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA), focusing on middle-aged adults with normal cognitive function at baseline. Changes in depressive symptoms were categorized into four groups based on the CES-D score, and their association with cognitive function decline was evaluated using a multivariate logistic regression model. Results: Of the initial 10,254 participants, 3,400 were included in the analysis. Depressive status, particularly newly onset (adjusted odds ratio [aOR] 1.96; 95% confidence interval [CI] 1.32-2.93) and persistent depression groups (aOR 5.59; 95% CI 2.90-10.78), were significantly associated with cognitive function decline. In contrast, recovery from depressive symptoms was not significantly associated with cognitive function decline (p=0.809). Conclusions: Our study showed a significant association between changes in depressive symptoms and cognitive function decline in middle-aged Korean adults. This suggests that management of depressive symptoms could be crucial for the prevention of cognitive function decline in this population.

Objectives : The aim of this study was to investigate predictors of cognitive function decline among community dwelling elderly. Methods : Data were analyzed from the Survey of Living Condition of Elderly panel study. Cognitive function was measured with the MMSE-KC at baseline and year 3. The study subjects were 5,464 community dwelling people aged 65 years or older who had no disability at baseline. Logistic regression analysis was used to predict cognitive function decline. Results : From 2008-2011, 4,417(80.8%) elderly people had no cognitive decline, and 1,074(19.2%) showed cognitive function decline measured by the MMSE-KC. After adjusting for demographics and baseline MMSE-KC score, the best predictors for cognitive function decline at 36 months were diabetes mellitus, smoking, low intensity physical activity, relationship with relatives and friends. Conclusions : Health promotion programs that are focused on the elderly are essential in preventing cognitive function decline. Promoting regular physical activity, and social relationships should be included in health promotion for elderly. When treating patients with diabetes, preventing cognitive impairment should be considered through education and counseling.

Objectives: The aim of this study was to investigate cognitive function decline by socio-demographic and health-related characteristics (health behaviors and health status) using 5th Korean Longitudinal Study of Aging panel data. Methods: The subjects were 4,440 community-dwelling people aged over 57 years. The data were analyzed with descriptive statistics, frequency analysis, χ²-test, and binary logistic regression analysis using SPSS ver. 25.0. Results: The findings revealed that socio-demographic characteristics (gender, age, area of residence, educational level, marital status, number of children, number of grand-children) and health-related characteristics (smoking, drinking, regular exercise, weight category by body mass index, hypertension and diabetes mellitus) were factors that influenced cognitive function decline (p<.05). Conclusions: Cognitive function decline was closely related to health behaviors and disease types. Future studies must examine related constructs to accurately determine these relationships among various populations. The present study could be used as a tool for the development and implementation of health promotion and prevention strategies.

Purpose: This study verified that the dual sensory impairment (DSI) in the elderly is associated with cognitive impairment (CI) and confirmed how change in cognitive function varies depending on the social support (SS). Methods: For a study sample of Korean older people, data from the Korean Longitudinal Study of Ageing (KLoSA) from the 7th (2018) to the 8th (2020), were included in this cross-sectional descriptive study. Among people who responded in both 2018 and 2020, a total of 2,069 people of those who are 65 years of age or older, and have living children and normal cognitive function, were analyzed. X2 -test, t-test and logistic regression analyses were utilized. Results: First, the number of elderly with visual impairment (VI), hearing impairment, and DSI increased on 8th data compared with 7th data. In addition, 22.9% of the 2,069 people showed a decrease in cognitive function. Second, compared to the elderly with normal sensory function, the cognitive function of the elderly with only VI was found to be more degraded, and the cognitive function of the elderly with DSI was found to be much more degraded. In addition, among SS, only participation in social gatherings was found to show significant change in cognitive function of the elderly with DSI. Third, the interaction effect of participating in social gatherings was not significant in the CI of the elderly with DSI. Conclusion: VI and DSI effected cognitive function, but participation in social gatherings such as SS has not significant interaction effect on CI of the elderly with DSI.

본 연구는 독거노인의 치매 위험인자 보유상태가 인지기능 저하에 미치는 영향요인임을 알아보기 위한 서술적 조사 연구이다. 지역사회에 거주하는 독거노인 143명을 대상으로 치매 위험인자를 파악하기 위한 간이 설문지, 노인우울척도, 치 매선별용 간이정신상태 검사를 실시하였다. 연구결과, 독거노인의 인지기능에 영향을 미치는 주요 요인은 무학과 초졸 이하 의 학력, 연령, 우울상태, 흡연, 여가활동, 성별 순으로 나타났다. 향후 독거노인을 대상으로 치매예방 전략을 마련하기 위해 서는 인지기능에 부정적인 영향을 주는 요인을 파악하여 인지건강에 도움을 줄 수 있는 생활습관의 변화와 다각적인 관리방 안을 모색해야할 필요성이 있다.

This study is a descriptive study to investigate the factors influencing the level of cognitive function among elderly living alone according to the presence of dementia risk factors. We conducted a simple questionnaire, GDS-K and MMSE-DS tests to investigate the risk of dementia among 143 elderly people living alone in the community. The results showed that the major factors influencing the cognitive function of the elderly people living alone were education, age, depression status, smoking, leisure activities, and gender. In order to develop strategies for the prevention of dementia in the elderly people living alone, it is necessary to change lifestyle and provide various management methods to identify risk factors that negatively affect cognitive function and to help cognitive health.

Background: In South Korea, as an aged society, an understanding of dementia and its risk factors is important from clinical and healthcare policy perspectives. Relationship between cognitive impairment and body weight or weight changes have been reported, but these were contradictory. We have evaluated the association between weight changes and cognitive decline using national level longitudinal data. Methods: Data from the Korean Longitudinal Study of Ageing from 2006 to 2012 were used. Association between weight changes and decline in cognitive function as measured by K-MMSE (the Korean version of the Minimental state examination) score was assessed by multivariate logistic regression. Weight changes were calculated from 1st wave and 3rd wave survey data, and classified into five groups as stable, increases, decreases of >10%, or 5%-10%. Results: About 37% of the total participants (n=4,512) were 65 years or older. These participants made up the largest proportion of the groups with weight change exceeding 10%. Multivariate logistic regression analyses revealed that weight changes exceeding 10% (10% increase vs stable, adjusted OR [aOR] 1.47, 95% confidence interval (CI) 1.11-1.95; 10% decrease vs stable, aOR 1.44, 95% CI 1.11-1.88) were significant predictive factors for decline in cognitive function. In subgroup analyses, the association between weight changes and cognitive decline was significant in males aged over 65 years and in normal BMI groups. Conclusion: Weight changes, both increases and decreases exceeding 10% of baseline, were significantly associated with declines in cognitive function among older adults in South Korea.

Objective The aims of our study were to identify distinct trajectories of cognitive function using the group-based trajectory model. We also investigate which demographic factors act as risk factors for cognitive decline in each group.Methods The data from the Seoul National University Hospital Healthcare System Gangnam Center, from 2005 to 2019. The number of study subjects was 637. We used a group-based model to identify cognitive function trajectories. Multinomial logistic regression was employed to define risk factors for cognitive function decline.Results The cognitive function trajectories among adults over 40 years of age were heterogeneous. We identified four trajectories: high (27.3%), medium (41.0%), low (22.7%), and rapid decline (9.1%). Older age, male, low educational level, bad dietary habits, diabetes mellitus, technical worker, and lower income increased the likelihood of a cognitive function decline.Conclusion A younger age, a higher educational level, professional worker, good dietary habits, no diabetes mellitus, and no obesity improved cognitive function. A combination of these factors can improve “cognitive reserve” and delay cognitive decline. Interventions to prevent cognitive decline are needed after identification of high-risk groups for cognitive decline.

본 연구는 40~59세와 60세 이상의 성인을 비교하여 건강 정보 이해도 차이를 분석하고, 신체적 정신적 웰빙에 미치는 영향을 평가했다. 2023년 국민건강영양조사에 참여한 40세 이상 4,617명의 데이터를 사용하여 SPSS Statistics v. 29를 통해 통계 분석을 실시했다. 연구 결과에 따르면 60세 이상의 성인은 40~59세에 비해 디지털 및 미디어 소스의 건강 정보 활용, 환자 교육 자료 이해, 건강 위험 인식 및 의료 지침 준수에 더 큰 어려움을 겪는 것으로 나타났다. 또한 노인은 신체 활동, 기억력, 수면, 통증, 에너지 수준 및 전반적인 웰빙과 관련된 더 많은 어려움을 보고했으며 건강 정보 이해는 삶의 질에 상당한 영향을 미쳤다. 이러한 결과를 감안할 때, 40세 이상의 성인, 특히 노인의 돌봄 제공자를 대상으로 하는 디지털 건강 정보 교육(Digital Health Literacy) 및 지원 프로그램에 대한 강력한 필요성과 미디어를 활용한 건강 행동 의사결정 능력 강화를 통한 삶의 질 개선을 추진할 필요가 있다.

This study analyzed the differences in health information literacy by comparing individuals aged 40?59 and those aged 60 or older and evaluated the impact on physical and mental well-being. Data from 4,617 adults aged 40 and older who participated in the 2023 Korea National Health and Nutrition Examination Survey were analyzed using SPSS Statistics v. 29. The findings revealed that adults aged 60 and older experienced greater challenges accessing and utilizing health information from digital and media sources. They also had more difficulty understanding patient education materials, recognizing health risks, and following medical guidelines than those aged 40?59. Furthermore, older adults reported more issues related to physical activity, memory, sleep, pain, energy, and overall well-being. Health information literacy was found to have a significant influence on quality of life, especially among older adults. These results highlight the importance of developing and implementing digital health literacy programs tailored to the needs of adults aged 40 and older. In particular, there is a strong need to support caregivers of older adults, as they play a critical role in managing health-related decisions. Enhancing media-based health literacy can empower individuals to make informed health behavior choices, ultimately promoting better quality of life across age groups.

본 연구의 목적은 한국 노인의 인지기능 저하에 영향을 미치는 요인을 파악하는 것이다. 본 연구는 2020년도 노인실태조사 원시자료를 활용한 2차 자료분석연구로, 65세 이상 노인인 총 10,095명을 대상자로 하였다. 자료는 SPSS 프로그램을 사용하여 기술통계, 교차분석, t-검정, 로지스틱 회귀분석 방법으로 분석하였다. 연구결과, 지역사회 거주 노인의 인지기능 저하에 유의한 영향을 미치는 요인으로 인구사회학적 영역에서 연령, 독거여부, 교육수준이, 건강상태 및 질병관련 특성에서 만성질환, 우울 증상, 근력상태, 일상생활수행능력, 씹기불편감이, 건강행태 특성에서는 흡연, 음주, 운동이 규명되었고, 이는 인지기능 저하의 22.0%를 설명하는 것으로 나타났다. 노인의 인지기능을 유지하고 개선하기 위해서는 만성질환의 조기 진단과 우울감 관리 및 건강한 생활습관 유지 등 다각적 접근이 필요함을 시사한다. 본 연구결과는 노인의 인지기능 저하 예방 및 개선을 위한 정책적, 실무적 근거로 사용될 수 있으며, 이를 바탕으로 한 노인 대상 보건정책 및 건강전략 제공이 필요하다.

The purpose of this study was to examine factors influencing cognitive decline among community-dwelling older adults in Korea. This secondary data analysis utilized data from the 2020 National Survey of Older Koreans, including 10,095 participants aged 65 and older. Data were analyzed using SPSS with descriptive statistics, chi-squared test, t-test, and logistic regression analysis. Results revealed that sociodemographic factors such as age, living alone, and educational level significantly influenced cognitive decline. Health and disease-related factors, including chronic diseases, depressive symptoms, muscle strength, ability to perform daily activities, and chewing discomfort, also played a significant role. Furthermore, health behaviors such as smoking, alcohol consumption, and exercise were identified as important factors. Collectively, these accounted for 22.0% of the variance in cognitive decline. The findings suggest that maintaining and improving cognitive function in older adults requires a multifaceted approach, including the early diagnosis of chronic diseases and depressive symptoms management, along with promoting healthy lifestyle behaviors. Health policies and strategies should be developed and implemented to prevent and mitigate cognitive decline in this target population.

The purpose of this study was to examine whether functional fitness predicts subsequent cognitive decline in community dwelling older adults. The subjects were 1094 (556 men and 538 women) adults aged 60 years or older who completed the baseline (2000-2002) and ten years later (2010-2012) examinations of the National Institute for Longevity Science-Longitudinal Study of Aging (NILS-LSA) in Japan. We examined associations at baseline and over a 10-year follow-up period between seven functional fitness measures: gait speed, step length, one leg standing, reaction time, leg extension power, grip strength and knee extension strength and mini-mental state examination (MMSE). Multivariate logistic regression was used to examine the relationships between functional fitness and cognitive function decline every two years. There was a significant association between the reaction time and risk of becoming decrease to 23 points of MMSE in both model Ⅰ and model Ⅱ of all waves in men and women for 10 years. Gait speed was related to decrease in the cognitive function from after six years (5th wave) in both men (OR, 0.72; CI, 0.53- 0.95) and women (OR, 0.79; CI, 0.54-0.97). Leg extension power and grip strength of the physical function were associated with cognitive function decline from after six years it was found in men only. In the women case, it was showed after 10 years. Functional fitness was identified as factors that can predict the decrease in cognitive function. But it turned out that the functional fitness related to cognitive function decreases depending on the time and gender are different.

본 연구의 목적은 한국노인의 성별에 따른 인지기능 저하와 관련된 요인을 규명하는 것이다. 본 연구는 2017년 전국노인실태조사 자료를 활용한 2차 자료 분석으로, 대상자는 총 9,862명의 65세 이상 노인이었다. 본 연구 자료는 SPSS Statistics 23.0을 이용하여기술 통계, 복합표본 교차 분석(Rao-Scott χ2 검정)과 t-검정(complex sample t-test), 복합표본 이분형 로지스틱 회귀 분석(binary logistic regression analysis)을 실시하였다. 연구결과, 본 연구에서 인지기능의 평균 점수는 여성 노인(24.50 ± 0.06)이 남성 노인(26.19 ± 0.06)보다낮게 나타났으나(p < .001) 인지기능 저하율은 남성노인(15.8%)이 여성노인(12.6%)보다 높게 나타났다(p<.001). 본 연구에서 남성노인과여성노인 모두에게 인지기능 저하와 관련된 공통 요인은 고위험 영양상태, 청력 불편함, 뇌졸중, 하지근력, 마음을 털어놓을 수 있는사람, 경제활동이었다. 남성노인은 이러한 공통 요인 외에도 심근경색증이, 여성노인에서는 공통 요인 외에 교육수준, 중위험 영양상태, 친구⋅이웃⋅지인과의 왕래빈도, 고지혈증, 독거, 운동능력이 인지기능 저하 관련 요인으로 나타났다. 이를 통해 본 연구는 한국노인의인지기능 저하를 예방하고 치매 유병률을 낮추기 위해서는 성별에 따른 인지기능 저하와 관련된 다차원적 요인을 고려한 접근 전략이필요함을 시사했으며 특히 여성노인의 인지기능 저하는 남성보다 더 다양한 요인들과 관련되어 있으므로 성별 특성에 맞게 차별화된인지기능 관련 포괄적 건강사정 전략을 모색하는 연구가 필요함을 제시해 주었다.

This purpose of this was to identify the factors associated with cognitive function decline according to gender in Korean elderly. This study was conducted with a secondary data analysis that used data from the 2017 National Survey on Elderly Status. The participants were 9,862 elderly. Data were analyzed using SPSS Statistics 23.0 to obtain descriptive statistics, cross-analysis (Rao-Scott χ2 test), complex sample t-test, and binary logistic regression analysis. The average score of cognitive function was lower in female elderly (24.50 ± 0.06) than male elderly (26.19 ± 0.06) (p < .001). But, the rate of cognitive decline was higher in male elderly (15.8%) than female elderly (12.6%) (p < .001). The common factors associated with cognitive function decline of the male and female elderly were high-risk nutritional status, hearing discomfort, stroke, lower extremity muscular strength, psychologically dependent object, and employment. Including these common factors, myocardial infarction in male elderly, and education level, moderate-risk nutritional status, frequency of interaction with friends, neighbors, and acquaintances, hyperlipidemia, living alone, and mobility in female elderly were found to be factors associated with cognitive function decline. In order to assess changes in the elderly's cognitive function and develop and apply a nursing intervention program to improve cognitive function, an approach that considers multidimensional factors associated with cognitive function decline according to gender is necessary. In particular, the cognitive function of elderly women is associated with various factors than men, therefore research to find differentiated strategies suitable for female characteristics should be conducted.

본 연구는 31명의 정상노인과 30명의 경도인지기능장애 노인을 대상으로 과거기억과 미래기억검사를 실시하여 인지기능저하에 따른 기억의 해리가 나타나는 지를 살펴보았다. 이를 위해 과거기억 검사는 CERAD-K의 단어목록기억검사를, 미래기억은 Rivermead Behavioral Memory Test의 약속기억검사와 소지품검사, 그리고 시계검사와 동물검사를 실시하였다. 그 결과, 과거기억을 평가한 단어목록기억검사의 즉시회상, 지연회상, 재인 모두 경도인지기능장애 노인이 정상노인보다 수행이 저조하였다. 그리고 경도인지기능장애 노인은 정상노인보다 미래기억의 소지품기억 및 약속기억 과제 수행이 저조하였다. 하지만, 시계검사와 동물검사의 수행에는 차이가 없었다. 이는 과거기억과 미래기억이 서로 독립적인 체계로 기능하고 있다는 것을 시사한다. 아울러 과제 특성에 따른 처리 수준이 미래기억 수행에 영향을 미칠 수 있다는 것을 보여준다.

This study examined the retrospective and prospective memory test of 31 normal elderly and 30 elderly with mild cognitive impairment to investigate a selective dissociation. The Word List Memory Test of CERAD-K for retrospective memory, Rivermead Behavioral Memory Test for prospective memory, animal test, and clock test were used in this test. As a result, the patients with MCI performed less than the normal elderly in the immediate recall, delayed recall, and recognition of the WLMT for evaluating retrospective memory. In addition, the patients with MCI performed less than the normal elderly in the memory test of personal belongings and promise for evaluating prospective memory. However, there was no difference between groups in the performance of clock test and animal test. This suggests that both retrospective and prospective memory individually function as an independent system. It also suggests that processing level depending on task characteristics can affect the performance of prospective memory. Future study could be a comparative study of the retrospective and prospective memory for dementia patients according to the pattern of cognitive decline.

Background: Alcohol consumption has been considered as a modifiable risk factor for dementia development and alcohol-related brain damage may further impair cognitive abilities in dementia patients. This study aimed to find out the differences in cognitive function according to current alcohol drinking in patients with self-perceived memory decline, including subjective cognitive decline (SCD), mild cognitive impairment (MCI) and early Alzheimer-type dementia (ATD). Methods: From May 2018 to December 2019, retrospective chart review was performed in patients who visited CHA Bundang Medical Center for cognitive decline. A two-way analysis of variance with interaction test were used to analyze the impact of alcohol consumption on cognitive function between groups. Results: A total of 147 patients was classified into three groups of SCD (n=30), MCI (n=53), and ATD (n=64), and each group was divided into two subgroups of alcohol users and alcohol non-users, according to the current status of alcohol consumption. Between SCD, MCI and ATD groups, scores of clock drawing test and Go/No-go test were significantly lower in current alcohol users of ATD groups compared to the SCD and MCI groups (p<0.05). Conclusions: These results suggest that current alcohol consumption has detrimental effects especially on the frontal/executive function in early ATD patients. Considering the association between frontal/executive function and ADL, our finding suggests that cessation of alcohol intake may be a therapeutic strategy to prevent ADL deterioration in patients with ATD

연구목적 치료를 마친 유방암 환자들에서 인지 저하가 나타난다는 것이 알려져 있다. 인지 저하는 항암치료, 암이라는 질병 자체의 영향, 우울과 불안을 포함하는 정서요인 등의 다양한 원인들에 의해 나타날 수 있다고 알려져 있다. 그러나 인지 저하가 항상 신경심리검사 결과와 일치하는 것은 아니었다. 이에 본 연구는 주관적 인지 저하가 객관적 인지기능 검사와 관련성이 있는지, 인지 저하의 관련요인은 무엇인지 알아보고자 하였다. 방 법 치료 종료 후 6개월이 지난 유방암 환자들 중 인지 저하를 호소하는 29명의 환자군과 동일한 연령대의 20명의 정상 대조군이 연구에 참여하였다. 모든 연구 참여자들을 대상으로 신경심리검사를 시행하였고, 이후 다중회귀분석을 통해 신경심리검사 점수와 우울, 불안을 포함하는 정서 요인과의 관련성을 평가하였고, 연령, 교육수준, 공존 질환과의 연관성도 함께 알아보았다. 결 과 유방암 환자군과 정상 대조군 간 신경심리검사 결과의 차이는 없었다. 정상 대조군에 비해 유방암 환자군에서 우울(p=0.002) 및 불안(p<0.001) 의 정도가 유의하게 높았다. 유방암 환자군 내에서 연령, 교육수준, 공존 질환을 통제하였을 때 실행기능의 저하는 높은 우울(${\beta}=-0.336$, p=0.001), 불안(${\beta}=-0.273$, p=0.009)의 정도와 유의한 관련이 있었다. 마찬가지로 주의력 저하도 높은 우울(${\beta}=-0.375$, p=0.023) 및 불안(${\beta}=-0.404$, p=0.013)의 정도와 유의한 상관관계를 보였다. 결 론 연구 결과 환자들의 주관적 인지 저하와 객관적 인지기능 검사 결과가 일치하지 않는다는 것을 알 수 있었다. 이는 주관적 인지 저하가 우울이나 불안과 같은 정서적 스트레스의 지표로 나타날 수 있음을 시사한다.

Objectives : Cognitive complaints are reported frequently after breast cancer treatments. The causes of cognitive decline are multifactorial, a result of the effect of cancer itself, chemotherapy, and psychological factors such as depression and anxiety. However, cognitive decline does not always correlate with neuropsychological test performance. The purpose of this study was to examine the relationship of subjective cognitive decline with objective measurement and to explore associated factors of cognitive function in breast cancer survivors. Methods : We included 29 breast cancer survivors who complain cognitive decline at least 6 months after treatment and 20 age-matched healthy controls. Neuropsychological tests were performed in all participants. Multivariable regression analysis evaluated associations between neuropsychological test scores and psychological distress including depression and anxiety, also considering age, education, and comorbidity. Results : There were no statistically significant differences in neuropsychological test performances. However, the breast cancer survivors showed a significantly higher depression(p=0.002) and anxiety(p<0.001) than the healthy controls did. Among the cancer survivors, poorer executive function was strongly associated with higher depression(${\beta}=-0.336$, p=0.001) and anxiety(${\beta}=-0.273$, p=0.009), after controlling for age, education, and comorbidity. In addition, poorer attention was also significantly related with depression(${\beta}=-0.375$, p=0.023) and anxiety (${\beta}=-0.404$, p=0.013). Conclusions : The results of this study showed the discrepancies between subjective complaints and objective measures of cognitive function in breast cancer survivors. It suggests that subjective cognitive decline could be indicators of psychological distress such as depression and anxiety.