노년기 인지기능 변화궤적과 관련 요인: 잠재성장모형의 적용
The Trajectory and Its Predictors of the Change of Cognitive Functioning among the Elderly-A Latent Growth Curve Analysis-
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본 연구의 목적은 노년기 인지기능의 변화궤적을 살펴보고 노년기 인지기능 변화에 영향을 미치는 관련 요인들의 종단적 영향을 밝히는 것이다. 이를 위해 본 연구는 한국고령화연구패널조사 1∼3차 조사자료를 활용, 1차 조사시점 당시 65세 이상이면서 전체 조사시점 동안 응답을 유지한 총 2,711명을 대상으로 잠재성장모형을 적용하여 분석하였다. 분석 결과 노인의 인지기능은 시간이 지남에 따라 점차 감소하며, 초기 인지기능이 높은 노인들일수록 시간이 지남에 따라 인지기능의 감소속도가 더딘 것으로 드러났다. 또한 노년기 인지기능을 예측하는 다양한 변수들의 초기치를 예측변수로 투입한 잠재성장모형의 조건부모형 분석 결과 연령 및 학력수준, 일상생활동작능력, 우울증상이 인지기능과 관련이 있는 것으로 드러났다. 연령이 높아질수록 시간이 지남에 따라 인지기능 감소속도가 느려졌으며, 학력수준이 높을수록 인지기능 감소속도가 느렸다. 또한 일상생활동작능력이 좋지 않을수록 인지기능 감소속도가 빨랐으며, 우울증상의 초기값이 높은 노인일수록 인지기능이 낮았다. 이와 같은 결과를 통해 본 연구는 지역사회 일반 노인들의 인지기능 저하의 원인을 이해하게 하는 강력한 정보를 제공함으로써 향후 인지기능 저하의 예방과 치료적 개입을 위한 서비스 마련에 일조할 수 있으리라 생각된다.
Abstract
The purpose of the current study were to investigate: 1) the trajectory of cognitive functioning and 2) its predictors in the trajectory using latent growth curve modeling involving individuals aged 65 and over who participated in the Korean Longitudinal Study of Aging from the Korea Labor Institute(N=2,711). The results show that participants’ cognitive functioning was decreased over 3 waves and the elderly who had higher cognitive functioning at time 1 tend to less decreased in cognitive functioning over time. Also, the findings indicated that age, educational level and activity of daily living were associated with the change of cognitive functioning. In detail, the older age, the higher educational level and the better activity of daily living were predictors the less decreasing in cognitive functioning. Based on these findings, this study discussed implications for intervention and future research.
참고문헌 (45)
- 강연욱, "정신상태간이검사" (1997), Human brain research and consulting
- 김은주, "재가노인의 인지기능장애에 영향을 미치는 요인", 동서간호학연구지, 16(2), pp.122~130 (2010), 동서간호학연구소
- 김홍근, "한국 노인의 연령, 교육수준, 성별이 인지기능 측정치들에 미치는 효과", Korean Journal of Clinical Psychology, 30(3), pp.681~701 (2011), 한국임상심리학회
- 오영희, "우리나라 노인의 주관적 건강인식과 신체적 및 정신적 기능상태의 관련성 연구", 한국노년학, 26(3), pp.461~476 (2006), 한국노년학회
- 이현주, "노년기 인지기능의 성별 및 연령 차이", 정신보건과 사회사업, (37), pp.255~278 (2011), 한국정신보건사회복지학회
- 전해숙, "노인 인지문제 개선 예측요인에 대한 탐색적 연구: 한국고령자패널데이터(KLoSA)를 이용하여", 보건사회연구, 33(2), pp.461~488 (2013), 한국보건사회연구원
- 정영미, "동거유형에 따른 노인의 인지기능, 영양상태, 우울의 비교", Journal of Korean Academy of Nursing, 34(3), pp.495~503 (2004), 한국간호과학회
- 치매노인 유병률 조사, "조맹제", 보건복지가족부, ~ (2008)
- 황종남, "중․고령자의 사회활동 참여와 인지기능과의 관계", 한국노년학, 29(3), pp.971~986 (2009), 한국노년학회
- Aartsen, M., "Activity in older adults, cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults", The journal of gerontology: Psychology science Scosial science, 57(2), pp.153~162 (2002)
- Albert, M., "Geriatric Neuropsychology", pp.13~32 (1988), Guilford Press
- Andersen, E., "Screening for depression in well older adults: Evaluation of a short form of the CES-D", American Journal of the Preventive Medicine, 1, pp.385~401 (1994)
- Ballard, C., "Prospective follow-up study between 3 and 15 months after stroke improvements and decline in cognitive function among dementia-free stroke survivors >75 years of age", Stroke, 34(10), pp.2440~2444 (2003)
- Barnes, D., "Depressive Symptoms, Vascular Disease, and Mild Cognitive Impairment Findings From the Cardiovascular Health Study", Archive General Psychiatry, 63(3), pp.273~279 (2006)
- Barnes, D., "Women who maintain optimal cognitive function into old age", Journal of American Geriatric Society, 55, pp.259~264 (2007)
- Bassuk, S., "Social disengagement and incident cognitive decline in community dwelling elderly persons", Ann Intern Med, 131, pp.165~173 (1999)
- Cerhan, J., "Correlates of cognitive function in middle-aged adults", Gerontology, 44, pp.95~105 (1998)
- Chodosh, J., "Depressive symptoms, chronic diseases, and physical disabilities as predictors of cognitive functioning trajectories in older Americans", Journal of the American Geriatrics Society, 58(12), pp.2350~2357 (2010)
- Chun, K., "Cognitive impairment and some related factors among the elderly residents in an urban area", Journal of Korean Public Health Association, 27, pp.112~119 (2001)
- R. Cooper, "Objectively measured physical capability levels and mortality: systematic review and meta-analysis", BMJ, 341(sep09 1), pp.c4467~c4467 (2010), BMJ[DOI]
- Clouston, S., "The dynamic relationship between physical function and cognition in longitudinal aging cohorts", Epidemiologic Reviews, 35, pp.33~50 (2013)
- Duncan, T., "An introduction to latent growth curve modeling", Behavior Therapy, 35(2), pp.333~363 (2004)
- Farias, S. T., "Demographic, neuropsychological and functional predictors of rate of longitudinal cognitive decline in Hispanic older adults", Am J Geriatr Psychiatry, 19(5), pp.440~450 (2011)
- Folstein, M., "Mini-mental state”:A practical method for grading the cognitive state of patients for the clinician", Journal of Psychiatric Research, 12(3), pp.189~198 (1975)
- Ganguli, M., "Age and education effects and norms on a cognitive test battery from a population-based cohort: The Monongahela-Youghiogheny healthy aging team", Aging and Mental Health, 14(1), pp.100~107 (2010)
- Geerlings, M., "Depression and risk of cognitive decline and Alzheimer’s disease: Results of two prospective community-based studies in the Netherlands", The British Journal of Psychiatry, 176, pp.568~575 (2000)
- Goh, J., "Differential trajectories of age-related changes in components of executive and memory processes", Psychological Aging, 27(3), pp.707~719 (2012)
- Green, A., "Influence of social network characteristics on cognitio and functional status with aging", International Journal of Geriatric Psychiatry, 23, pp.972~978 (2008)
- Hedden, T., "Insights into the ageing mind: a view from cognitive neuroscience", Nat Rev Neurosci, 5, pp.87~96 (2004)
- Hu, L., "Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives", Structural equation modeling: A Multidisciplinary Journal, 6(1), pp.1~55 (1999)
- Kahn, R., "성공적인 노화" (2002), 신정
- Lindwall, M., "Dynamic association of change in physical activity and change in cognitive function", Journal of Aging Research, pp.1~12 (2012)
- Luck, T., "Mild cognitive impairment", JAGS, 58, pp.1903~1910 (2010)
- Radloff, L., "The CES-D scale: A self-report depression scale for research in the general population", Applied Psychological measurement, 1, pp.385~401 (1977)
- Ronnlund, M., "Stability, growth, and decline in adult life span development of declarative memory: Cross-sectional and longitudinal data from a population-based study", Psychology and Aging, 20, pp.3~18 (2005)
- Rowe, J., "Successful aging", The Gerontologist, 37, pp.433~440 (1997)
- Salthouse, T., "When does age-related cognitive decline begin?", Neurobiol Aging, 30, pp.507~514 (2009)
- Seeman, T., "Histories of social engagement and adult cognition", The Journal of Gerontology, 66B(S1), pp.144~152 (2011)
- Shim, Y., "Clinical characteristics of demented patients in a geriatric institution: Focused on behavioral and psychological symptoms", Korea Dementia Association, 4, pp.35~40 (2005)
- Studenski, S., "Gait speed and survival in older adults", JAMA, 305(1), pp.50~58 (2011)
- Wolf, H., "The prognosis of mild cognitive impairment in the elderly", J Neural Transm Suppl, 54, pp.31~50 (1998)
- Won, J., "Influencing factors on cognitive function and depression in elderly", Journal of Psychiatric Nursing, 12, pp.148~154 (2003)
- Zunzunegui, M., "Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults", J Gerontol B Psychol Sci Soc Sci, 58(2), pp.S93~S100 (2003)
- "치매역학조사결과보고서" (2012), 치매정보 365[URL]
- "Measuring Model fit" (2014)[URL]