Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

Younhee Kang; Sun A Whang; Kuemju Park

doi:10.7475/kjan.2015.27.6.656

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Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

Younhee Kang¹, Sun A Whang², Kuemju Park³

Korean Journal of Adult Nursing 2015;27(6):656-664.
Published online: December 31, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.6.656

¹Division of Nursing, College of Health Sciences, Ewha Womans University, Seoul

²Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul

³Department of Nursing Science, The University of Suwon, Suwon, Korea

Corresponding author: Kang, Younhee Division of Nursing, College of Health Sciences, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-4483, Fax: +82-2-3277-2850, E-mail: yxk12@ewha.ac.kr

• Received: August 31, 2015 • Accepted: December 12, 2015

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.

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Abstract
REFERENCES

Abstract

Purpose
The purposes of this study were to identify the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) among the community-dwelling elderly and to determine if there were differences in cognitive function, leisure activities, and exercises between the group with MCI-maintained and the group with reversion to NC.
Methods
This study utilized a longitudinal descriptive comparative design. A total of 346 subjects over age 65 was recruited from public health center at baseline. Finally 152 elderly were enrolled at 1 year follow-up. Data were collected through MoCA-K, K-MMSE, KDSQ-C5 and questionnaires on leisure activities and exercises. Data were analyzed by IBM SPSS Statistics 21.0 using descriptive statistics, x² test, and t-test.
Results
The rate of reversion from MCI to NC among the subjects was 44.1%. At baseline, the group with MCI-maintained had lower cognitive function than the group with reversion to NC. At 1 year follow-up, the group with reversion to NC had higher subjective cognitive function than the group with MCI-maintained. Regarding leisure activities, there were differences between the groups at baseline and 1 year follow-up.
Conclusion
It is suggested that age, education year, subjective cognitive function, and leisure activities should be considered at planning a nursing intervention for MCI.
Key Words: Mild cognitive impairment; Leisure activity; Exercise

Table 1.

MET (Metabolic Equivalent)

METs	Types of exercise
2.5	Billiards
3	Bowling, gate ball, dumbbell
3.5	Hang glider
4	Walking, golf, yoga, hypogastric breathing
4.5	Weight lifting, table tennis, canoe, badminton, volleyball, horse-riding
5	Basketball, survival game, headstand, dodge ball, baseball, horizontal bar exercise, dancing, freehand exercise
5.5	Bicycle riding, calisthenics, fitness, foot volleyball, aerobics
6	Kendo, swimming, fencing, water-skiing, hula hoop
7	Football, tennis, ice skating, running, jogging, soccer, roller skating
8	Push-up, boxing, judo, teukgongmoosool, hiking, handball, karate, sit-up, ssireum, kung fu, wrestling, climbing stairs, hapkido
10	Kickboxing, martial arts, jump rope, taekwondo
12	Squash

Table2.

RateofNCGroupwith Reversionto NC, Groupwith MCI Maintained and Group with Progress to Dementia (N=152)

Groups	n(%)
Group with reversion to NC	67(44.1)
Group with MCI maintained	81(53.3)
Group with progress to dementia	4(2.6)

NC=normal cognition; MCI=mild cognitive impairment.

Table3.

Comparisonsof General CharacteristicsbetweenGroupwith Reversionto NCandGroupwith MCI Maintainedat Base (N=148)

Characteristics	Categories	Group with reversion to NC (n=67)	Group with MCI maintained (n=81)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Gender	Male	18 (26.9)	21 (25.9)	0.02	.522
Gender	Female	49 (73.1)	60 (74.1)	0.02	.522
Age (year)		71.9±5.5	74.9±5.7	-3.31	.001
	65~74	48 (71.6)	38 (46.9)	-	-
	75~84	19 (28.4)	37 (45.7)
	85 ≥		6 (7.4)
Education years		8.70±4.71	5.02±4.74	4.71	.001 ＜
	0~5	11 (16.4)	41 (50.6)	18.94	.001 ＜
	6~8	22 (32.8)	17 (21.0)
	9~11	14 (20.9)	9 (11.1)
	12 ≥	20 (29.9)	14 (17.3)
Marital status	With spouse	40 (59.7)	36 (44.4)	3.42	.071
Marital status	Without spouse	27 (40.3)	45 (55.6)	3.42	.071

NC=normal cognition; MCI=mild cognitive impairment.

Table 4.

Comparison of Cognitive Function, Leisure Activity and Exercise between the Group with Reversion to NC and the Group with MCI Maintained (N=148)

Characteristics	Categories	Group with reversion to NC (n=67)	Group with MCI maintained (n=81)	t	p
Characteristics	Categories	M±SD	M±SD	t	p
Objective cognitive function (MoCA-K)	Baseline	20.60±1.61	17.65±3.41	6.89	.001 ＜
Objective cognitive function (MoCA-K)	1 year F/U	25.12±1.68	18.60±3.32	15.43	.001 ＜
Subjective cognitive function (KDSQ-C5)	Baseline	2.78±2.04	3.46±2.55	-1.77	.080
Subjective cognitive function (KDSQ-C5)	1 year F/U	2.01±1.94	2.96±2.30	-2.72	.007
Leisure activity (times/year)	Baseline	793.67±372.41	666.91±343.35	2.15	.033
	Watching TV	329.57±103.29	334.73±97.78
	Listening radio	105.57±160.74	75.44±136.46
	Reading newspapers	165.75±165.91	101.24±152.98
	Reading books	138.58±157.71	95.10±143.13
	Playing games	30.31±69.71	38.65±101.37
	Participating cultural class	14.57±33.58	15.24±43.53
	Others	9.33±50.24	6.5±42.13
	1 year F/U	812.04±319.38	678.80±271.21	2.75	.007
	Watching TV	357.99±41.30	362.74±20.33
	Listening radio	97.57±154.95	51.09±125.60
	Reading newspapers	149.52±170.19	100.94±156.65
	Reading books	116.80±156.34	117.49±160.78
	Playing games	30.86±87.44	33.44±95.99
	Participating cultural class	29.10±75.53	6.81±20.72
	Others	30.21±94.80	6.30±20.93
Exercise (Kcal/week)	Baseline	926.20±1,230.57	889.90±1,253.03	0.18	.860
	3 MET 5 ≤ ＜	1,037.63±725.72	1,058.97±605.02
	5 MET 7 ≤ ＜	1,257.30±809.61	1,288.14±738.98
	7 MET ≤	1,598.29±1,009.36	2,601.46±2,148.50
	1 year F/U	925.64±1,186.95	815.00±1,284.12	0.54	.590
	3 MET 5 ≤ ＜	1,104.29±675.55	1,032.27±594.38
	5 MET 7 ≤ ＜	916.14±785.60	1,167.92±836.62
	7 MET ≤	2,000.40±1028.63	3,941.33±2,505.23

NC=normal cognition; MCI=mild cognitive impairment; MET=metabolic equivalent.

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Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

Korean J Adult Nurs. 2015;27(6):656-664. Published online December 31, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.6.656

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Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

Korean J Adult Nurs. 2015;27(6):656-664. Published online December 31, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.6.656

Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

Table 1.

MET (Metabolic Equivalent)

METs	Types of exercise
2.5	Billiards
3	Bowling, gate ball, dumbbell
3.5	Hang glider
4	Walking, golf, yoga, hypogastric breathing
4.5	Weight lifting, table tennis, canoe, badminton, volleyball, horse-riding
5	Basketball, survival game, headstand, dodge ball, baseball, horizontal bar exercise, dancing, freehand exercise
5.5	Bicycle riding, calisthenics, fitness, foot volleyball, aerobics
6	Kendo, swimming, fencing, water-skiing, hula hoop
7	Football, tennis, ice skating, running, jogging, soccer, roller skating
8	Push-up, boxing, judo, teukgongmoosool, hiking, handball, karate, sit-up, ssireum, kung fu, wrestling, climbing stairs, hapkido
10	Kickboxing, martial arts, jump rope, taekwondo
12	Squash

Table2.

RateofNCGroupwith Reversionto NC, Groupwith MCI Maintained and Group with Progress to Dementia (N=152)

Groups	n(%)
Group with reversion to NC	67(44.1)
Group with MCI maintained	81(53.3)
Group with progress to dementia	4(2.6)

NC=normal cognition; MCI=mild cognitive impairment.

Table3.

Comparisonsof General CharacteristicsbetweenGroupwith Reversionto NCandGroupwith MCI Maintainedat Base (N=148)

Characteristics	Categories	Group with reversion to NC (n=67)	Group with MCI maintained (n=81)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Gender	Male	18 (26.9)	21 (25.9)	0.02	.522
Gender	Female	49 (73.1)	60 (74.1)	0.02	.522
Age (year)		71.9±5.5	74.9±5.7	-3.31	.001
	65~74	48 (71.6)	38 (46.9)	-	-
	75~84	19 (28.4)	37 (45.7)
	85 ≥		6 (7.4)
Education years		8.70±4.71	5.02±4.74	4.71	.001 ＜
	0~5	11 (16.4)	41 (50.6)	18.94	.001 ＜
	6~8	22 (32.8)	17 (21.0)
	9~11	14 (20.9)	9 (11.1)
	12 ≥	20 (29.9)	14 (17.3)
Marital status	With spouse	40 (59.7)	36 (44.4)	3.42	.071
Marital status	Without spouse	27 (40.3)	45 (55.6)	3.42	.071

NC=normal cognition; MCI=mild cognitive impairment.

Table 4.

Comparison of Cognitive Function, Leisure Activity and Exercise between the Group with Reversion to NC and the Group with MCI Maintained (N=148)

Characteristics	Categories	Group with reversion to NC (n=67)	Group with MCI maintained (n=81)	t	p
Characteristics	Categories	M±SD	M±SD	t	p
Objective cognitive function (MoCA-K)	Baseline	20.60±1.61	17.65±3.41	6.89	.001 ＜
Objective cognitive function (MoCA-K)	1 year F/U	25.12±1.68	18.60±3.32	15.43	.001 ＜
Subjective cognitive function (KDSQ-C5)	Baseline	2.78±2.04	3.46±2.55	-1.77	.080
Subjective cognitive function (KDSQ-C5)	1 year F/U	2.01±1.94	2.96±2.30	-2.72	.007
Leisure activity (times/year)	Baseline	793.67±372.41	666.91±343.35	2.15	.033
	Watching TV	329.57±103.29	334.73±97.78
	Listening radio	105.57±160.74	75.44±136.46
	Reading newspapers	165.75±165.91	101.24±152.98
	Reading books	138.58±157.71	95.10±143.13
	Playing games	30.31±69.71	38.65±101.37
	Participating cultural class	14.57±33.58	15.24±43.53
	Others	9.33±50.24	6.5±42.13
	1 year F/U	812.04±319.38	678.80±271.21	2.75	.007
	Watching TV	357.99±41.30	362.74±20.33
	Listening radio	97.57±154.95	51.09±125.60
	Reading newspapers	149.52±170.19	100.94±156.65
	Reading books	116.80±156.34	117.49±160.78
	Playing games	30.86±87.44	33.44±95.99
	Participating cultural class	29.10±75.53	6.81±20.72
	Others	30.21±94.80	6.30±20.93
Exercise (Kcal/week)	Baseline	926.20±1,230.57	889.90±1,253.03	0.18	.860
	3 MET 5 ≤ ＜	1,037.63±725.72	1,058.97±605.02
	5 MET 7 ≤ ＜	1,257.30±809.61	1,288.14±738.98
	7 MET ≤	1,598.29±1,009.36	2,601.46±2,148.50
	1 year F/U	925.64±1,186.95	815.00±1,284.12	0.54	.590
	3 MET 5 ≤ ＜	1,104.29±675.55	1,032.27±594.38
	5 MET 7 ≤ ＜	916.14±785.60	1,167.92±836.62
	7 MET ≤	2,000.40±1028.63	3,941.33±2,505.23

NC=normal cognition; MCI=mild cognitive impairment; MET=metabolic equivalent.

Table 1. MET (Metabolic Equivalent)

Table2. RateofNCGroupwith Reversionto NC, Groupwith MCI Maintained and Group with Progress to Dementia (N=152)

NC=normal cognition; MCI=mild cognitive impairment.

Table3. Comparisonsof General CharacteristicsbetweenGroupwith Reversionto NCandGroupwith MCI Maintainedat Base (N=148)

NC=normal cognition; MCI=mild cognitive impairment.

Table 4. Comparison of Cognitive Function, Leisure Activity and Exercise between the Group with Reversion to NC and the Group with MCI Maintained (N=148)

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Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

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