뇌졸중이 인지기능에 미치는 효과: 노인용 인지검사(CSOA)를 중심으로
Effects of Stroke on Cognitive Functions Measured by the Cognition Scale for Older Adults
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뇌졸중이 인지기능에 미치는 효과를 노인용 인지검사(CSOA)를 사용하여 검증하였다. 피검자는 뇌졸중 환자 31명과 정상 노인 30명이었다. 주요 결과는 다음 세 가지였다. 첫째, 뇌졸중군과 통제군을 비교한 결과 뇌졸중군이 통제군에 비해 낮은 정도는 기초지능에 비해 관리지능에서 보다 현저하였다. 둘째, 뇌졸중군내에서 NCI(무인지장애)군, VCI(혈관성 인지장애)군, VAD(혈관성 치매)군을 비교한 결과 각 군 공히 기초지능 저하에 비해 관리지능 저하가 보다 현저하였다. 셋째, 좌뇌 뇌졸중 환자는 우뇌 뇌졸중 환자에 비해 언어기능 및 언어기억이 낮았다. 이상의 결과는 뇌졸중에 따른 인지기능 변화 중 가장 핵심적인 것이 관리기능 저하임을 제시한다. 뇌졸중군에서 관리기능 저하가 현저한 것은 다수의 환자들이 전두-피질하회로(frontal-subcortical circuit)의 손상을 가진 것을 반영할 수 있다. 본 연구의 결과는 CSOA가 임상에서 한국 노인의 인지기능 평가에 효과적으로 적용될 수 있음을 보여준다.
Abstract
The aim of the present study was to investigate effects of stroke on cognitive functions measured by the Cognitive Scale for Older Adults (CSOA). The test assesses cognitive measures such as basic IQ, Executive IQ, language function, and verbal memory function. The participants were 31 stroke patients and 30 normal age-matched controls. There were three main findings. First, stroke patients had lower Basic IQ as well as lower Executive IQ scores compared to normal controls. The between-group difference was greater in Executive IQ relative to Basic IQ. Second, NCI (No Cognitive Impairment), VCI (Vascular Cognitive Impairment), and VAD (Vascular Dementia) groups were similar in showing lower Executive IQ relative to Basic IQ. Third, left-brain lesioned patients showed lower language function scores well as lower verbal memory function scores than right-brain lesioned patients. These results indicate that cognitive dysfunction following stroke is most severely evident as lowered scores in executive function relative to normal controls. The neural correlates of post-stroke executive dysfunction may be lesions affecting the frontal-subcortical circuits. The results also indicate clinical utility of CSOA in measuring cognitive functions of Korean older adults.
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