Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
권호 표지
DOI QR코드

DOI QR Code

Improvement of Attention and Short-term Memory of Mild Dementia Using iPad Applications: A Single Case Study

아이패드를 이용한 경도 치매 노인의 주의집중력과 단기 기억력 증진 : 단일대상연구

  • Hwangbo, Seung Woo (Division of Occupational Science and Occupational Therapy, University of Southern California) ;
  • Kim, Moon-Young (Dept. of Occupational Therapy, The Graduate School, Yonsei University) ;
  • Kim, Jongbae (Dept. of Occupational Therapy, College of Health Science, Yonsei University) ;
  • Park, Hae Yean (Dept. of Occupational Therapy, College of Health Science, Yonsei University)
  • 황보승우 ;
  • 김문영 (연세대학교 일반대학원 작업치료학과) ;
  • 김종배 (연세대학교 보건과학대학 작업치료학과) ;
  • 박혜연 (연세대학교 보건과학대학 작업치료학과)
  • Received : 2018.07.19
  • Accepted : 2018.08.14
  • Published : 2018.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : This study was conducted to investigate the effects of iPad applications on improvement of attention and short-term memory in mild dementia. Methods : A single-case experimental study using A-B-A design was conducted. A total of 20 sessions, including 5 each for baseline phase A and A' and 10 for the intervention phase, were provided to the subject. Interventions were only provided during the intervention phase and were iOS-based iPad applications named "Memorado-Moving Balls" and "Circles." "Fit Brains-Matching Pairs" and "Fit-Brains-Spot the Difference" were used for each session to evaluate attention and short-term memory. MMSE-K, K-TMT-e A and B, and DST assessment tools were used pre- and post-intervention to assess attention and memory. Result : Fit Brains scores indicated improvement in both attention and memory during the intervention phase. K-TMT-e A showed 3 increased correct points and 3 reduced error points, and B showed 7 increased correct points and 2 reduced error points in post-tests, but the DST and MMSE-K showed no meaningful change. Conclusion : This single-case study identified improvements in attention and short-term memory in a person with mild dementia using iPad applications. Further studies regarding different applications and larger samples with long-term designs are necessary.

목적 : 본 연구의 목적은 경도 치매 노인의 주의 집중력과 기억력 향상을 위한 아이패드 어플리케이션 중재법의 효과를 알아보기 위함이며, 중재법의 효과를 통하여 임상현장의 작업치료사에게 근거를 제시하고자 한다. 연구방법 : 경도 치매 노인 한 명을 대상으로 단일대상연구 중 ABA 설계로 연구를 진행하였다. 총 20회기를 기초선 A 5회기, 중재기 B 10회기, 기초선 A' 5회기로 나누어서 각 회기별 30분씩 진행되었다. 중재기 때는 'Memorado-움직이는 공, '와 'Circles'라는 두 어플리케이션으로 주의 집중력 및 기억력 훈련을 실시하였고, 매 회기마다 Fit Brains의 '짝 맞추기, '와 '틀린 그림 찾기'로 주의 집중력과 기억력 수준의 변화를 평가하였다. 또한 사전 및 사후 평가로 한국판 노인형 기호잇기검사, 숫자외우기 검사, 한국판 간이 정신상태 검사를 실시하였다. 결과 : Fit Brains '짝 맞추기'와 '틀린 그림 찾기'를 매 회기 시행해본 결과 중재기부터 주의 집중력과 기억력이 향상되는 것을 확인할 수 있었다. 사전 및 사후 평가로 실시된 한국판 노인형 기호잇기검사는 전, 후 대비 A형의 경우 정답 수 3점 증가, 오류 수 3점 감소, B형의 경우 정답 수 7점 증가, 오류 수 2점 감소를 보여 점수변화를 나타냈으나, 숫자외우기 검사와 한국판 간이 정신상태 검사에서는 점수 변화가 미미하였다. 결론 : 본 연구는 아이패드 어플리케이션 중재방법을 통해 경도 치매 노인의 집중력과 기억력의 향상을 확인하였고, 추후 연구에서는 다양한 어플리케이션과 더 많은 표본을 대상으로 장기간 진행될 필요가 있을 것이다.

Keywords

References

  1. 김은수. (2006). 한국 실버산업의 활성화방안에 관한 연구. 국제신학, 8, 351-396.
  2. 박근태. (2012). 노인스마트폰 사용자 10 명 중 6 명 애플리케이션 이용. 조선비즈. Retrieved from http://biz.chosun.com/site/data/html_dir/2012/06/28/2012062801255.html
  3. 보건복지부. (2012). 2012 년 치매 유병률 조사. 보건복지부 보도자료.
  4. 통계청. (2016). 장애인구추계: 2015-2065. 통계청 보도자료.
  5. Arrighi, H. M., Gelinas, I., McLaughlin, T. P., Buchanan, J., & Gauthier, S. (2013). Longitudinal changes in functional disability in Alzheimer's disease patients. International Psychogeriatrics, 25(06), 929-937. https://doi.org/10.1017/S1041610212002360
  6. Abu-Ghanem, S., Handzel, O., Ness, L., Ben-Artzi-Blima, M., Fait-Ghelbendorf, K., & Himmelfarb, M. (2015). Smartphone-based audiometric test for screening hearing loss in the elderly. European Archives of Oto-Rhino-Laryngology, 1-7.
  7. Behl, P., Edwards, J. D., Kiss, A., Lanctot, K. L., Streiner, D. L., Black, S. E., & Stuss, D. T. (2014). Treatment effects in multiple cognitive domains in Alzheimer's disease: A two-year cohort study. Alzheimer's Research & Therapy, 6(4), 48. doi.org/10.1186/alzrt280
  8. Boulos, M. N., Wheeler, S., Tavares, C., & Jones, R. (2011). How smartphones are changing the face of mobile and participatory healthcare: An overview, with example from eCAALYX. Biomedical Engineering Online, 10(1), 24. doi. org/10.1186/1475-925X-10-24
  9. Cho, H., & Ko, Z. (2012). Current state of senile dementia and improvement of the long term care insurance for elderly people. Journal of the Korean Academia-Industrial Cooperation Society, 13(12), 5816-5825. https://doi.org/10.5762/KAIS.2012.13.12.5816
  10. Cho, M., Kim, D., Chung, J., Park, J., You, H., & Yang, Y. (2015). Effects of a cognitive-enhancement group training program on daily living activities, cognition, and depression in the demented elderly. Journal of Physical Therapy Science, 27(3), 681-684. doi. org/10.1589/jpts.27.681
  11. Crossland, M. D., S Silva, R., & Macedo, A. F. (2014). Smartphone, tablet computer and e-reader use by people with vision impairment. Ophthalmic and Physiological Optics, 34(5), 552-557. doi. org/10.1111/opo.12136
  12. Dobbs, D., Munn, J., Zimmerman, S., Boustani, M., Williams, C. S., Sloane, P. D., & Reed, P. S. (2005). Characteristics associated with lower activity involvement in long-term care residents with dementia. The Gerontologist, 45(suppl 1), 81-86. doi. org/10.1093/geront/45.suppl_1.81
  13. Gunther, V. K., Schufer, P., Holzner, B. J., & Kemmler, G. W. (2003). Long-term improvements in cognitive performance through computer-assisted cognitive training: A pilot study in a residential home for older people. Aging & Mental Health, 7(3), 200-206. doi. org/10.1080/1360786031000101175
  14. Herrera, C., Chambon, C., Michel, B. F., Paban, V., & Alescio-Lautier, B. (2012). Positive effects of computer-based cognitive training in adults with mild cognitive impairment. Neuropsychologia, 50(8), 1871-1881. doi.org/10.1016/j.neuropsychologia.2012.04.012
  15. Huntley, J. D., Gould, R. L., Liu, K., Smith, M., & Howard, R. J. (2015). Do cognitive interventions improve general cognition in dementia? A meta-analy sis and meta-regression. BMJ open, 5(4), e005247. dx.doi.org/10.1136/bmjopen-2014-005247
  16. Kanaan, S. F., McDowd, J. M., Colgrove, Y., Burns, J. M., Gajewski, B., & Pohl, P. S. (2014). Feasibility and efficacy of intensive cognitive training in early-stage Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 29(2), 150-158. doi. org/10.1177/1533317513506775
  17. Kang, Y., Chin, J., & Na, D. L. (2002). A normative study of the digit span test for the elderly. Korean Journal of Clinical Psychology, 21(4), 911-922.
  18. Kim, H., & Park., T. (2003). Korean norm for the difference between digits forward and digits backward. Korean Journal of Clinical Psychology, 22(3), 599-613.
  19. Kim, J. M., Shin, I. S., Yoon, J. S., & Lee, H. Y. (2003). Comparison of diagnostic validities between MMSE-K and K-MMSE for screening of dementia. Journal of Korean Neuropsychiatric Association, 42(1), 124-30.
  20. Kim, S. Y. (2003). Factors affecting on the QOL of the demented elderly caregivers: Suggestions of political alternatives. Soc Welf Policy, 17, 77-105.
  21. Lee, I. (2014). Improvement of attention and memory of stroke patient using smart phone applications: Single case study. Therapeutic Science for Neurorehabilitation, 3(1), 57-65.
  22. Maeng, I. K. (2009). A Study of dementia old man's actual conditions and treatment plan(Masters thesis). Hoseo University, Asan.
  23. Mioshi, E., Hodges, J. R., & Hornberger, M. (2013). Neural correlates of activities of daily living in frontotemporal dementia. Journal of Geriatric Psychiatry and Neurology, 26(1), 51-57. https://doi.org/10.1177/0891988713477474
  24. Leng, F. Y., Yeo, D., George, S., & Barr, C. (2013). Comparison of iPad applications with traditional activities using person-centred care approach: Impact on well-being for persons with dementia. Dementia, 13(2), doi.org/10.1177/1471301213494514
  25. Reitz, C., & Mayeux, R. (2014). Alzheimer disease: Epidemiology, diagnostic criteria, risk factors and biomarkers. Biochemical Pharmacology, 88(4), 640-651. doi.org/10.1016/j.bcp.2013.12.024
  26. Samson, S., Clement, S., Narme, P., Schiaratura, L., & Ehrle, N. (2015). Efficacy of musical interventions in dementia: Methodological requirements of nonpharmacological trials. Annals of the New York Academy of Sciences, 1337(1), 249-255. doi. org/10.1111/nyas.12621
  27. Sung, K. H. (2006). Burden and depression of caregivers according to cognitive function and daily living ability of dementia patients(Masters thesis). Ewha Womans University, Seoul.
  28. Yi, H. (2006). Development & Validation of Korean version of Trail making test for Elderly persons(Masters thesis). Sungkyunkwan University, Seoul.
  29. Yi, H., Chin, J., Lee, B. H., Kang, Y., & Na, D. L. (2007). Development and validation of Korean version of trail making test for elderly persons. Dementia and Neurocognitive Disorders, 6(2), 54-67.
  30. Yoon, H. K. (2003). Research Analysis on the Present of Koreas Silver Industry and Silver Product Design. Journal of Korean Society of Design Science, 16(2), 151-160.