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노년층, 기억상실형 경도인지장애, 치매환자의 담화산출 손상 정도에 따른 점수화 방법

Scoring Method According to Severity of Impaired Discourse Production in Normal Elderly, Amnestic Mild Cognitive Impairment, and Dementia

김보선|이미숙
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2019.03|특수교육재활과학연구|제58권 제1호|pp. 347-365|DOI 10.23944/Jsers.2019.03.58.1.15

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참고문헌

키워드

dementia치매경도인지장애담화DiscourseCoherence응집성Cohesion통일성MCIPropositional analysis명제분석
주제분류기타사회과학

초록

정상노년층, 기억상실형 경도인지장애(amnestic mild cognitive impairment, aMCI), 치매집단이 산출한 담화에 대한 분석이 이루어져왔으나, 이는 담화 수행 자체에 대한 정보로 전반적인 담화수행 정도를 점수화하여 나타내고자 한 시도는 없었다. 이에 본 연구는 통일성, 응집성, 명제, 쉼에 따른 담화수행 정도를 각 영역별로 점수화하고, 담화수행총점을 제시한다. 즉, 전반적인 담화수행 정도를 각 점수를 통해 집단별로 비교해 보고자 한다. 또한, 각 영역별 점수 및 총점이 타 언어검사 및 간이 정신상태 검사(the Korean mini-mental state examination, K-MMSE)와 상관성이 있는지 조사한다. 본 연구의 대상자는 12명의 정상 노년층, 12명의 aMCI 집단, 12명의 치매집단으로 각 대상자들에게 K-MMSE를 포함한 인구통계학적 설문이 시행되었고, 동물 범주의 의미유창성 검사, 대면이름대기 검사 (Short Form of the Korean Version-the Boston Naming Test, K-BNT-15), 담화과제가 시행되었다. 그 결과, 집단 별 차이를 보인 담화수행 하위 영역은 응집성과 명제 점수에서였으며, 담화수행총점은 세 집단 모두를 변별하였다. 또한, 정상군에서는 발화상 쉼이 적을수록 의미유창성 점수가 높았고, aMCI 집단에서는 담화의 통일성이 높을수록 K-MMSE 점수가 높았다. 치매집단에서는 담화수행총점이 높을수록 K-BNT-15의 점수가 높았다. 본 연구는 노년층의 인지 저하에 따른 세 집단의 담화수행력을 점수화함으로써 담화산출 손상의 중증도 정도를 점수화하여 제시할 수 있는 기반을 마련하였다. 또한, 각 저하된 담화수행 영역 및 관련 인지기능에 초점을 두어 일상생활에서의 의사소통에 방해가 되는 영역의 담화 중재를 위한 구체적인 목표를 세우는 데 도움을 줄 수 있을 것이다.

Abstract

Various analyses have been conducted to investigate the discourses produced by the normal elderly, amnestic mild cognitive impairment (aMCI), and dementia groups. However, there has been no attempt to score the overall performance of the discourse production of each group. Therefore, in this study, the degree of discourse impairment with coherence, cohesion, proposition, and pause is scored and is presented with the total discourse scores. In addition, this study investigated whether the scores of each area and the total discourse scores are associated with the scores of language tests and the Korean mini-mental state examination (K-MMSE). The participants were 12 normal elderly, 12 aMCI patients, and 12 patients with dementia. A demographic questionnaire including K-MMSE, a semantic verbal fluency (animal), the K-BNT-15 (short form of the Korean version-the Boston Naming Test), and the discourse task were conducted. As a result, the scores of cohesion and proposition and total discourse scores significantly differentiated the three groups.In addition, in the normal elderly group, the lower the pause score was, the higher the verbal fluency score was. In the aMCI group, the higher the coherence score was, the higher the score of K-MMSE was. In the dementia group, the score of K-BNT-15 was higher as the total discourse score was higher. This study firstly attempted to score the degree of discourse impairment severity according to the cognitive declines of the elderly. It may also helpful to set specific goals for discourse and cognitive interventions by providing the degraded scores of specific areas from discourse performance.

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