The Effects of an Individual Cognitive Improvement Program on the Elderly with Mild Cognitive Impairments

Inhyae Park; In-Hee Choi; Seo Young Kang; Younkyoung Kim; Chong Mi Lee

doi:10.12799/jkachn.2015.26.1.1

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Park, Choi, Kang, Kim, and Lee: The Effects of an Individual Cognitive Improvement Program on the Elderly with Mild Cognitive Impairments

Original Article

Journal of Korean Academy of Community Health Nursing 2015; 26(1): 1-10.

Published online: 31 March 2015

DOI: https://doi.org/10.12799/jkachn.2015.26.1.1

The Effects of an Individual Cognitive Improvement Program on the Elderly with Mild Cognitive Impairments

Inhyae Park¹, In-Hee Choi², Seo Young Kang², Younkyoung Kim³, Chong Mi Lee⁴

¹College of Nursing, Chonnam National University, Chonnam Research Institute of Nursing Science, Gwangju, Korea.

²Department of Nursing, Gwangju Health College, Gwangju, Korea.

³Department of Nursing, Gwangju University, Gwangju, Korea.

⁴Chosun Nursing College, Gwangju, Korea.

Corresponding author: Kim, Younkyoung. Department of Nursing, Gwangju University, 277 Hyodeck-ro, Nam-gu, Gwangju 503-703, Korea. Tel: +82-62-670-2919, Fax: +82-62-670-2058, ykim2013@gwangju.ac.kr

Received 27 November 2014 Revised 29 December 2014 Accepted 6 February 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to investigate changes in cognitive functions, depression and life-satisfaction for elderly participants with mild cognitive impairments participating in an individual cognitive improvement program.

Methods

A quasi-experimental with non-equivalent control group pretest-posttest design was implemented. The participants were senior citizens over 65 years of age who had been clinically diagnosed with mild cognitive impairments in G City and J Province (experimental group: 29, control group: 27). The experimental group participated in the individual cognitive improvement program based on Korean traditional tales and games for nine weeks.

Results

After the intervention, only the participants in the experimental group reported significant improvement in K-MMSE (t=-2.5, p=.016), MoCA-K (t=-2.6, p=.008), depression (t=3.51, p=.001), and life satisfaction (t=-2.75, p=.008) when compared to those in the control group.

Conclusion

These results indicated that the individual cognitive improvement program was effective in improving cognitive functions, depression, and life-satisfaction among the elderly with mild cognitive impairments. Therefore, the application of this individual cognitive improvement program developed in this study by visiting nurses may strengthen the cognitive functions of seniors with mild cognitive impairments.

Keywords: Mild cognitive impairment, Aged, Program development

Figures and Tables

Table 1

Cognitive Improvement Program based on Korean Traditional Tales and Games

Session	Contents	Items to prepare
1	Introduction, obtaining written informed consent, pre-test	Consent form, questionnaires for pre-test
2	Kongjwi and Patjwi	Cotton flannel board, picture images, the script, five stones
	- Introduction, main activities
	- Playing gonggi (fivestones)
3	Kongjwi and Patjwi	Cotton flannel board, picture images, the script, colored papers
	- Introduction, main activities
	- Making origami (a Korean style jacket)
4	Kongjwi and Patjwi	Cotton flannel board, picture images, the script, clay
	- Introduction, main activities
	- Making household items in clay
5	Hyungbo and Nahibo	Cotton flannel board, picture images, the script, small bean-bags
	- Introduction, main activities
	- Playing with small bean-bags
6	Hyungbo and Nahibo	Cotton flannel board, picture images, the script, colored papers
	- Introduction, main activities
	- Making origami (swallow)
7	Middle-test	Questionnaires for middle-test
8	Hyungbo and Nahibo	Cotton flannel board, picture images, the script, hardboard, colored papers, glue, colored pencils
	- Introduction, main activities
	- Making origami (house)
9	Sim Chung, the dutiful daughter	Cotton flannel board, picture images, the script
	- Introduction, main activities
	- Playing Ssalbab and Boribab
10	Sim Chung, the dutiful daughter	Cotton flannel board, picture images, the script, colored papers
	- Introduction, main activities
	- Making origami (flowers)
11	Sim Chung, the dutiful daughter	Cotton flannel board, picture images, the script, colored hardboard
	- Introduction, main activities
	- Making Dakji, playing Dakjichigi (picture cards in chilrens game)
12	End of program, post-test	Questionnaires for post-test

Table 2

General Characteristics and Homogeneity

Characteristics	Categories	n (%)	Exp. (n=29)	Cont. (n=27)	χ²	p
Characteristics	Categories	n (%)	n (%)	n (%)	χ²	p
Gender	Male	4 (7.1)	1 (3.4)	3 (11.1)	1.24	.266^†
Gender	Female	52 (92.9)	28 (96.6)	24 (88.9)	1.24	.266^†
Age (year)	65~74	11 (20.0)	8 (27.6)	3 (11.5)	2.49	.289^†
	75~84	35 (63.6)	16 (55.2)	19 (73.1)
	≥85	9 (16.4)	5 (17.2)	4 (15.4)
Education year	None	24 (43.6)	13 (44.8)	11 (42.3)	0.55	.760^†
	≤6	23 (41.8)	11 (37.9)	12 (46.2)
	≥7	8 (14.5)	5 (17.2)	3 (11.5)
Marital status	Unmarried	1 (1.8)	1 (3.4)	0 (0.0)	0.95	.330^†
Marital status	Married	55 (98.2)	28 (96.6)	27 (100.0)	0.95	.330^†
Family relationships or family support	Very satisfied	0 (0.0)	0 (0.0)	0 (0.0)	4.31	.230^†
	Satisfied	22 (39.3)	11 (37.9)	11 (40.7)
	Moderate	17 (30.4)	6 (20.7)	11 (40.7)
	Unsatisfied	14 (25.0)	10 (34.5)	4 (14.8)
	Very unsatisfied	3 (5.4)	2 (6.9)	1 (3.7)
Smoking	No smoker	49 (87.5)	26 (89.7)	23 (85.2)	2.32	.314^†
	Ex-smoker	5 (8.9)	3 (10.3)	2 (7.4)
	Smoker	2 (3.6)	0 (0.0)	2 (7.4)
Current disease	Yes	54 (96.4)	28 (96.6)	26 (96.3)	0.00	.959^†
Current disease	No	2 (3.6)	1 (3.4)	1 (3.7)	0.00	.959^†
Health status	Very healthy	0 (0.0)	0 (0.0)	0 (0.0)	1.02	.797^†
	Healthy	6 (10.7)	3 (10.3)	3 (11.1)
	Moderate	14 (25.0)	8 (27.6)	6 (22.2)
	Unhealthy	30 (53.6)	14 (48.3)	16 (59.3)
	Very unhealthy	6 (10.7)	4 (13.8)	2 (7.4)
Excercise (per week)	None	22 (39.3)	7 (24.1)	15 (55.6)	5.87	.053
	1~2	13 (23.2)	8 (27.6)	5 (18.5)
	≥3	21 (37.5)	14 (48.3)	7 (25.9)
Regular diets	Yes	44 (78.6)	23 (79.3)	21 (77.8)	0.02	.889
Regular diets	No	12 (21.4)	6 (20.7)	6 (22.2)	0.02	.889
Nutritive conditions	Very satisfied	1 (1.8)	0 (0.0)	1 (3.7)	2.62	.624^†
	Satisfied	11 (19.6)	4 (13.8)	7 (25.9)
	Moderate	19 (33.9)	11 (37.9)	8 (29.6)
	Unsatisfied	23 (41.1)	13 (44.8)	10 (37.0)
	Very unsatisfied	2 (3.6)	1 (3.4)	1 (3.7)

^†Fisher's exact test; Exp.=experimental group; Cont.=control group.

Table 3

Homogeneity of Two Groups at the Pretest

Outcome measures	Exp. (n=29)	Cont. (n=27)	t	p
Outcome measures	M±SD	M±SD	t	p
K-MMSE	20.7±4.59	19.4±4.59	1.02	.315
MoCA-K	15.2±4.83	13.6±6.39	1.05	.299
Depression	23.5±8.59	23.7±10.79	-0.11	.922
Life satisfaction	16.6±8.21	16.3±6.69	0.11	.914

Exp.=experimental group; Cont.=control group.

Table 4

Differences between Groups in K-MMSE, MoCA-K, Depression, and Life Satisfaction

Outcome measures	Groups	Pretest	Posttest	Difference	t	p
Outcome measures	Groups	M±SD	M±SD	M±SD	t	p
K-MMSE	Exp. (n=29)	20.7±4.59	22.9±4.44	-2.2±2.51	-2.50	.016
K-MMSE	Cont. (n=27)	19.4±4.59	20.1±4.59	-0.7±2.06	-2.50	.016
MOCA-K	Exp. (n=29)	15.2±4.83	18.0±5.67	-2.8±2.53	-2.60	.012
MOCA-K	Cont. (n=27)	13.6±6.39	14.2±5.63	-0.6±3.63	-2.60	.012
Depression	Exp. (n=29)	23.5±8.59	17.7±8.82	5.8±7.33	3.51	.001
Depression	Cont. (n=27)	23.7±10.79	24.2±10.26	-0.5±5.91	3.51	.001
Life satisfaction	Exp. (n=29)	16.6±8.21	21.8±8.46	-5.2±6.56	-2.75	.008
Life satisfaction	Cont. (n=27)	16.3±6.69	16.6±8.18	-0.3±6.88	-2.75	.008

Exp.=experimental group; Cont.=control group.

Notes

This Study was conducted(in part) by research funds from Gwangju University in 2015.

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