본문 바로가기
KERD
논문KCI 등재

주관적 인지 저하와 경도인지장애에 대한 가정 기반 인지-의사소통 중재의 효과

Efficacy of Home-based Cognitive-Communication Intervention for Subjective Cognitive Decline and Mild Cognitive Impairment

이미숙
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2022.12|특수교육재활과학연구|제61권 제4호|pp. 309-340|DOI 10.23944/Jsers.2022.12.61.4.14

1

조회

0

다운로드

6

인용

0

참고문헌

키워드

Mild cognitive impairment경도인지장애효과 차이Subjective cognitive decline주관적 인지 저하Home-based인지-의사소통 중재Cognitive-communication intervention가정 기반Effect Difference
주제분류기타사회과학

초록

치매의 고위험군인 주관적 인지 저하(SCD)와 경도인지장애(MCI)에 대한 인지-의사소통 중재를 통해 삶의 질(QoL)을 제고할 필요가 있다. 본 연구에서는 SCD 및 MCI를 대상으로 가정 기반 인지-의사소통 중재의 효과를 알아본 후 집단 간의 효과 차이를 비교하였다. 이를 위해 SCD 19명과 MCI 22명이 3개월간 주의력, 작업기억, 고차원적 인지, 의사소통으로 구성된 가정 기반 중재에 참여하였다. 연구 결과는 다음과 같다. 첫째, SCD와 MCI 집단은 주의력, 구어 및 비구어 작업기억, 고차원적 인지 등 모든 인지 영역에서 중재 전후에 유의한 향상을 보였다. 둘째, 두 집단은 이해, 표현, 화용언어, 주관적 의사소통 등 4개 의사소통 영역 모두에서 중재 효과가 있었다. 셋째, SCD 집단의 전반적 QoL은 중재 전후에 유의미한 차이가 있었다. 넷째, 두 집단 간에 중재 효과가 큰 영역은 주의력, 구어 작업기억, 고차원적 인지, 화용언어였다. 본 연구를 통해 가정 기반 인지-의사소통 중재가 SCD 및 MCI 집단에 효과적이며, 집단 간에 효과 차이가 다름을 알 수 있었다. 이는 두 집단에 대한 통합적 가정 기반 중재를 고안하고 효과성을 제고하는 데 주요 임상 지침으로 활용할 수 있다.

Abstract

Individuals with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are at high risk for dementia. It is necessary to intervene in them considering cognitive-communication and quality of life (QoL). The purpose of this study was to analyze the effects of home-based cognitive-communication intervention for SCD and MCI. We also compared the differences in efficacy between them. SCD (n=19) and MCI (n=22) groups performed three months of intervention protocol regarding attention, working memory, higher order cognition, and communication. The main findings were as follows. Firstly, SCD and MCI groups improved significantly in attention, working memory (verbal/nonverbal), and higher order cognition. Secondly, the efficacy of two groups was significant in all domains of communication including comprehension, expression, pragmatic language, and subjective communication. Thirdly, SCD group improved significantly in general QoL. Lastly, there is a great deal of effect difference in attention, verbal working memory, higher order cognition, and pragmatic language between two groups. The results suggest that home-based cognitive-communication intervention is largely effective, and differences in effect are diverse in SCD and MCI groups. This study provides practical guidelines for developing the integrated home-based protocols, and increasing their effects in two groups.

참고문헌 (78)

  1. Bahar-Fuchs, A., "Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer’s disease and vascular dementia", The Cochrane Database of Systematic Reviews, 2013(6) (2013)
  2. Belleville, S., "Training-related brain plasticity in subjects at risk of developing Alzheimer’s disease", Brain, 134(6), pp.1623~1634 (2011)
  3. Borella, E., "Working memory training in older adults : Evidence of transfer and maintenance effects", Psychology and Aging, 25(4), pp.767~778 (2010)
  4. Burton, R. L., "Cognitive rehabilitation and telehealth videoconferencing: Developing an accessible intervention for subjective cognitive impairment, mild cognitive impairment, and dementia", Doctor, pp.2017
  5. Buschert, V. C., "Effects of a newly developed cognitive intervention in amnestic mild cognitive impairment and mild Alzheimer’s disease : A pilot study", Journal of Alzheimer’s Disease, 25(4), pp.679~694 (2011)
  6. Caramelli, P., "Subjective memory complaints and cognitive performance in a sample of healthy elderly", Dementia and Neuropsychologia, 2(1), pp.42~45 (2008)
  7. Cavallini, E., "Self-help memory training for healthy older adults in a residential care center : Specific and transfer effects on performance and beliefs", International Journal of Geriatric Psychiatry, 30(8), pp.870~880 (2015)
  8. Cho, M. J., "Validation of Geriatric Depression Scale, Korean version (GDS) in the assessment of DSM-III-R major depression", Journal of Korean Neuropsychiatric Association, 38(1), pp.48~63 (1999)
  9. 최혜윤, "‘ASHA 의사소통 삶의 질 척도’의 한국어판 번안: 청소년용", Communication Sciences and Disorders, 16(3), pp.388~396 (2011), 한국언어청각임상학회
  10. Cowan, N., "Models of verbal working memory capacity : What does it take to make them work", Psychological Review, 119(3), pp.480~499 (2012)
  11. Cruice, M., "The contribution and impact of the International Classification of Functioning, Disability and Health on quality of life in communication disorders", International Journal of Speech-Language Pathology, 10(1-2), pp.38~49 (2008)
  12. Dodge, H. H., "Web-enabled conversational interactions as a method to improve cognitive functions : Results of a 6-week randomized controlled trial", Alzheimer's and Dementia : Translational Research and Clinical Interventions, 1(1), pp.1~12 (2015)
  13. Forte, R., "Health and quality of life perception in older adults : The joint role of cognitive efficiency and functional mobility", International Journal of Environmental Research and Public Health, 12(9), pp.11328~11344 (2015)
  14. Greenaway, M. C., "The memory support system for mild cognitive impairment : Randomized trial of a cognitive rehabilitation intervention", International Journal of Geriatric Psychiatry, 28(4), pp.402~409 (2013)
  15. Hickey, E., "Dementia Person-Centered Assessment and Intervention" (2018), Routledge
  16. 홍윤정, "Efficacies of Cognitive Interventions in the Elderly with Subjective Cognitive Decline: A Prospective, Three-Arm, Controlled Trial", Journal of Clinical Neurology, 16(2), pp.304~313 (2020), 대한신경과학회
  17. Hoogendam, Y. Y., "Patterns of cognitive function in aging : the Rotterdam study", European Journal of Epidemiology, 29, pp.133~140 (2014)
  18. Hoogenhout, E., "Effects of a comprehensive educational group intervention in older women with cognitive complaints : A randomized controlled trial", Aging and Mental Health, 16(2), pp.135~144 (2012)
  19. Huckans, M., "Efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI) in older adults: Working toward a theoretical model and evidence-based interventions", Neuropsychology Review, 23(1), pp.63~80 (2013)
  20. Jessen, F., "The characterisation of subjective cognitive decline", The Lancet Neurology, 19(3), pp.271~278 (2020)
  21. Jessen, F., "A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease", Alzheimer's and Dementia, 10(6), pp.844~852 (2014)
  22. Kane, M. J., "The generality of working memory capacity : A latent-variable approach to verbal and visuospatial memory span and reasoning", Journal of Experimental Psychology : General, 133(2), pp.189~217 (2004)
  23. 강연욱, "K-MMSE(Korean-Mini Mental State Examination)의 노인 규준 연구", 한국심리학회지:일반, 25(2), pp.1~12 (2006), 한국심리학회
  24. Kang, Y. W., "Seoul Neuropsychological Screening Battery" (2003), Human Brain Research & Consulting Co
  25. Kielhofner, G., "The model of human occupation : Theory and application" (2002), Lippincott Williams & Wilkins
  26. Kim, B. H., "Cognitive profiles of subjective cognitive decline and clinical implications of its subgroups based on memory strategy types", Master, pp.2015
  27. Klimova, B., "Computer-based training programs for older people with mild cognitive impairment and", or dementia, 2017, pp.11, ~
  28. 이미숙, "노인의 의사소통 관련 삶의 질에 대한 영향 요인: 삶의 질, 인지, 심리·정서적 요인과의 상관성을 중심으로", Audiology and Speech Research, 15(3), pp.232~240 (2019), 한국청각언어재활학회
  29. 이미숙, "경도인지장애의 인지-의사소통 중재를 위한 과제별 수행 프로파일", 특수교육재활과학연구, 60(3), pp.187~211 (2021), 특수교육재활과학연구소[DOI]
  30. Lee, M. S., "Aging and cognitive-communication disorders" (2021), Koonja Publishing
  31. Mi Sook Lee, "The Profile of Task Performances for Cognitive-communicative Intervention in the Oldest-Old", Audiology and Speech Research, 17(4), pp.380~390 (2021), 한국청각언어재활학회
  32. Mi Sook Lee, "The Efficacy of Cognitive-Communicative Intervention in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis", Audiology and Speech Research, 17(2), pp.147~167 (2021), 한국청각언어재활학회
  33. 이미숙, "주관적 인지 저하의 인지-의사소통 예측인자: 체계적 고찰 및 메타분석", 특수교육재활과학연구, 61(1), pp.299~324 (2022), 특수교육재활과학연구소[DOI]
  34. Lee, M. S., "Effects of working memory intervention on language production by individuals with dementia", Neuropsychological Rehabilitation (2020)[DOI]
  35. Lee, M. S., "Brief Test of Cognitive-Communication Disorders (BCCD)" (2021), Inpsyt
  36. Lemons, P. P., "Questions for assessing higher-order cognitive skills:It’s not just Bloom’s", CBE Life Sciences Education, 12(1), pp.47~58 (2013)
  37. Lezak, M. D., "Neuropsychological Assessment" (2004), Oxford University Press
  38. Li, B. Y., "The role of cognitive activity in cognition protection : From bedside to bench", Translational Neurodegeneration, 6(1) (2017)
  39. Lin, F., "Cognitive and neural effects of vision-based speed-of-processing training in older adults with amnestic mild cognitive impairment : A pilot study", Journal of the American Geriatrics Society, 64(6), pp.1293~1298 (2016)
  40. López-Higes, R., "Efficacy of cognitive training in older adults with and without subjective cognitive decline is associated with inhibition efficiency and working memory span, not with cognitive reserve", Frontiers in Aging Neuroscience, 10 (2018)
  41. López-Higes, R., "Factors explaining language performance after training in elders with and without subjective cognitive decline", Frontiers in Aging Neuroscience, 10 (2018)
  42. López-Sanz, D., "Functional connectivity disruption in subjective cognitive decline and mild cognitive impairment : A common pattern of alterations", Frontiers in Aging Neuroscience, 9 (2017)
  43. Lu, Y. Y. F., "Satisfaction with a family-focused intervention for mild cognitive impairment dyads", Journal of Nursing Scholarship, 48(4), pp.334~344 (2016)
  44. Lu, Y. Y. F., "Content Validity and acceptability of the daily enhancement of meaningful activity program intervention for mild cognitive impairment patient-spouse dyads", Journal of Neuroscience Nursing, 43(6), pp.317~328 (2011)
  45. Lu, Y. Y. F., "Pilot testing a couples-focused Intervention for mild cognitive impairment", The Journal of Gerontological Nursing, 51(5), pp.16~23 (2013)
  46. Macoir, J., "Reduced lexical access to verbs in individuals with subjective cognitive decline", American Journal of Alzheimer’s Disease and Other Dementias, 34(1), pp.5~15 (2019)
  47. Melrose, R. J., "The use of Information and Communication technology when completing instrumental activities of daily living", Computers in Human Behavior, 63, pp.471~479 (2016)
  48. Miller, L. S., "Cognitive performance in centenarians and the oldest old: Norms from the Georgia centenarian study", Neuropsychology, Development, and Cognition. Section B, Aging, Neuropsychology and Cognition, 17(5), pp.575~590 (2010)
  49. Min, S. K., "Korean Version of WHOQOL" (2000), Hana mpc
  50. Morris, J. C., "The clinical dementia rating(CDR) : Current version and scoring rules", Neurology, 43(11), pp.2412~2414 (1993)
  51. Pang, Y., "Effects of smartphone-based compensatory cognitive training and physical activity on cognition, depression, and self-esteem in women with subjective cognitive decline", Brain Sciences, 11(8) (2021)
  52. Panza, F., "Late-life depression, mild cognitive impairment, and dementia: Possible continuum?", American Journal of Geriatric Psychiatry, 18(2), pp.98~116 (2010)
  53. Paul, D. R., "Quality of Communication Life Scale" (2004), ASHA
  54. Petersen, R. C., "Mild cognitive impairment as a diagnostic entity", Journal of Internal Medicine, 256(3), pp.183~194 (2004)
  55. Pike, K. E., "Face-name memory training in subjective memory decline: How does office-based training translate to everyday situations?", Aging, Neuropsychology, and Cognition, 25(5), pp.724~752 (2018)
  56. Rami, L., "The Subjective Cognitive Decline Questionnaire (SCD-Q): A validation study", Journal of Alzheimer’s Disease, 41(2), pp.453~466 (2014)
  57. Rey-Mermet, A., "Inhibition in aging : What is preserved? What declines? A meta-analysis", Psychonomic Bulletin and Review, 25(5), pp.1695~1716 (2018)
  58. Roberts, J. L., "Meta-representational awareness in mild cognitive impairment : An interpretative phenomenological analysis", Aging and Mental Health, 17(3), pp.300~309 (2013)
  59. Roenker, D. L., "Speed-of-processing and driving simulator training result in improved driving performance", Human Factors : The Journal of the Human Factors and Ergonomics Society, 45(2), pp.218~233 (2003)
  60. Roland, K. P., "Meaningful activity for persons with dementia : Family caregiver perspectives", American Journal of Alzheimer's Disease and Other Dementias, 30(6), pp.559~568 (2015)
  61. Savundranagam, M. Y., "Investigating the effects of communication problems on caregiver burden", Journal of Gerontology : Social Sciences, 60(1), pp.S48~S55 (2005)[DOI]
  62. Schmitter-Edgecombe, M., "Cognitive rehabilitation multi-family group intervention for individuals with mild cognitive impairment and their care-partners", Journal of the International Neuropsychological Society, 20(9), pp.897~908 (2014)
  63. Sherman, D. S., "The efficacy of cognitive intervention in mild cognitive impairment(MCI) : A metaanalysis of outcomes on neuropsychological measures", Neuropsychology Review, 27(4), pp.440~484 (2017)
  64. Schultz, S. A., "Subjective memory complaints, cortical thinning, and cognitive dysfunction in middle-age adults at risk of AD", Alzheimer’s and Dementia: Diagnosis, Assessment and Disease Monitoring, 1(1), pp.33~40 (2015)
  65. Shune, S., "Verbal play as a discourse resource in the social interactions of older and younger communication pairs", Journal of Interactional Research in Communication Disorders, 5(2), pp.193~216 (2014)
  66. Simons, D. J., "Do ‘brain-training’ programs work", Psychological Science in the Public Interest, 17(3), pp.103~186 (2016)
  67. Sims, T., "Information and communication technology use is related to higher well-being among the oldestold", The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 72(5), pp.761~770 (2017)
  68. Tappen, R. M., "The effect of in-home cognitive training on functional performance of individuals with mild cognitive impairment and early-stage", Alzheimer’s Disease Research in Gerontological Nursing, 7(1), pp.14~24 (2013)
  69. Teng, E., "Reduced quality-of-life ratings in mild cognitive impairment : Analyses of subject and informant responses", The American Journal of Geriatric Psychiatry, 20(12), pp.1016~1025 (2012)
  70. Uekermann, J., "Proverb interpretation changes in aging", Brain and Cognition, 67(1), pp.51~57 (2008)
  71. Unützer, J., "Impact investigators improving mood-promoting access to collaborative treatment. collaborative care management of late-life depression in the primary care setting: A randomized controlled trial", JAMA, 288(22), pp.2836~2845 (2002)
  72. van der Meulen, M., "Selective interference with image retention and generation : Evidence for the workspace model", The Quarterly Journal of Experimental Psychology, 62(8), pp.1568~1580 (2009)
  73. Vermeij, A., "Prefrontal activation may predict working-memory training gain in normal aging and mild cognitive impairment", Brain Imaging and Behavior, 11(1), pp.141~154 (2017)
  74. Willis, S. L., "Long-term effects of cognitive training on everyday functional outcomes in older adults", JAMA, 296(23), pp.2805~2814 (2006)
  75. Wright, H. H., "Story processing ability in cognitively healthy younger and older adults", Journal of Speech, Language, and Hearing Research, 54(3), pp.900~917 (2011)
  76. Yeom, T., "A manual for K-WAIS" (1992), Korea Psychology
  77. Yesavage, J. A., "Development and validation of a geriatric depression screening scale : A preliminary report", Journal of Psychiatric Research, 17(1), pp.37~49 (1982)
  78. Yuill, N., "A systematic review of cognitive stimulation therapy for older adults with mild to moderate dementia : An occupational therapy perspective", Occupational Therapy International, 18(4), pp.163~186 (2011)

관련 논문AI추천

주관적 인지 저하 노인의 의사소통 파트너 교육이 인지-의사소통 중재에 미치는 영향이미숙특수교육재활과학연구소 · 특수교육재활과학연구2023 · 제62권 제2호경도인지장애에 대한 작업기억 기반 의사소통 중재의 효과이미숙특수교육재활과학연구소 · 특수교육재활과학연구2022 · 제61권 제3호경도인지장애의 인지-의사소통 중재를 위한 과제별 수행 프로파일이미숙특수교육재활과학연구소 · 특수교육재활과학연구2021 · 제60권 제3호경도인지장애 성인 대상의 다분야 중재 및 언어기능 개선에 대한 국내 문헌 연구장찬, 김소담, 윤지혜특수교육재활과학연구소 · 특수교육재활과학연구2023 · 제62권 제3호초기 치매 노인의 의사소통 파트너 참여형 인지-의사소통 중재 효과에 대한 영향 요인이미숙특수교육재활과학연구소 · 특수교육재활과학연구2024 · 제63권 제2호통합적 인지-의사소통 중재 모델을 구성하는 변인의 비교: 경도인지장애와 일반 노인의 프로파일을 중심으로이미숙특수교육재활과학연구소 · 특수교육재활과학연구2025 · 제64권 제1호

이 간행물의 다른 논문 (15건)

고등학생의 공감능력과 장애학생 수용태도의 관계에서 자아존중감의 매개효과: 중국 허난성 중심으로리이씬, 강영심, 옥혜숙pp. 1-23다문화교육 접근법에 기초한 사회과 교과서의 장애 관련 내용에 대한 비판적 분석박남수, 박지현pp. 25-46반응적 상호작용 전략 중심의 양육자 교육이 유아-양육자의 상호작용에 미치는 영향: 단일대상 연구를 중심으로 한 메타분석김은연, 장유경pp. 47-61성인 지적장애인의 고등학교 통합교육의 의미김건희, 박혜지pp. 63-83보편적 학습설계 기반 온라인 수업 분석 체크리스트 개발이종운, 문동오, 김용성pp. 85-111
원문 보기