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PURPOSE: The objective of this study was to determine how anxiety and/or depressive symptoms differentially affect specific cognitive domains over time in persons with subjective cognitive decline (SCD). DESIGN: A longitudinal, observational study was conducted using data from the National Alzheimer’s Coordinating Center-Uniform Data Set. Mean follow-up was 4.1±2.4 years. METHODS: Using information from a total of 1,401 participants (age 74.0±8.2 years), linear mixed-effects regression models were used to assess longitudinal changes in global cognition, episodic memory, attention, language, and executive function by baseline psychological (anxiety [A] and/or depressive [D]) symptoms in individuals with SCD. Reference was the group having no symptoms (A−/D−). FINDINGS: The A+/D− group was not associated with any cognitive changes. The A−/D+ group was associated with a greater decline in episodic memory and executive function. The A+/D+ group had a greater decline in attention. Changes in global cognition and language were not predicted by any psychological symptoms. CONCLUSIONS: Depressive symptoms predicted lower episodic memory and executive function. CLINICAL RELEVANCE: Nurses need to pay attention to depressive symptoms in older adults with SCD because managing depressive symptoms may help protect against cognitive decline more typical of early Alzheimer’s dementia.

This review aimed to evaluate the effects of multi-domain interventions on cognition among individuals without dementia. Multi-domain interventions refer to those combining any single preventive measure such as physical activity, cognitive training, and/or nutrition to prevent dementia. Seventeen studies were included (n = 10,056 total participants; mean age = 73 years), eight of which were rated as strong in quality while the other nine showed moderate quality. The standardized mean difference (SMD; d) was used to calculate the effect size for each included study. Multi-domain interventions consisting of physical activity, cognitive training, cardioprotective nutrition, and/or cardiovascular health education exerted beneficial effects on global cognition, episodic memory, and/or executive function with very small to moderate effect sizes (0.16–0.77). Nurses may consider combining these components to potentially stave off dementia. Future research is warranted to identify the optimal multi-domain intervention components that can induce clinically significant beneficial effects on cognition.

Spouses often assume the role of informal caregivers for older adults living with mild cognitive impairment (MCI). These couples represent a population with low levels of physical activity, however, there is limited research regarding promotion of physical activity among these dyads. The purpose of this study was to evaluate the feasibility of a dyadic intervention, hypothesized to enhance physical activity via mutual support. We recruited three dyads (mean age: 66 [MCI] and 67 [spouse] years) from a local memory clinic. The dyads were asked to engage in physical activity together for 16 weeks. The weekly intervention consisted of 150 minutes of moderate-to-vigorous physical activity (MVPA) on their own and two lower body strength training sessions per week, one videoconferencing-supervised and one on their own. The adherence rate to the weekly MVPA and strength training was 88% and 83%, respectively. However, the percentage meeting the goal of 150 minutes/week of MVPA as measured using a Fitbit was 31% and 73% among those with MCI and spouses, respectively. There were no issues with the retention rate (100%) or safety; satisfaction scores were high (MCI = 93%, spouses = 98%). Exit interviews revealed three key themes: (1) value of the program (accountability, togetherness), (2) difficulties (differences in physical capacity between spouses), and (3) suggestions to improve the program (incorporating various types of strength training). Our dyadic intervention was feasible to support regular physical activity for older adults living with MCI and their spouses. Future work will incorporate participants’ feedback to optimize the intervention.

The objective of the current retrospective cohort study was to identify vascular and/or neuropsychiatric risk factors predicting clinical progression in persons with subjective cognitive decline (SCD). Information on 1,525 persons with SCD (mean age = 73.8 [ SD = 8.1] years) was obtained from the National Alzheimer's Coordinating Center. Clinical progression occurred from SCD to either amnestic mild cognitive impairment or Alzheimer's dementia over an average of 4.7 ( SD = 2.9) years. Stepwise Cox regression was used. Compared to obesity (hazard ratio [HR] = 0.59) in the univariate unadjusted model, obesity (HR = 0.64), current smoking (HR = 2.02), and depressive symptoms (HR = 1.35) were significant after adjusting for covariates in the univariate model. In the multivariate adjusted model, obesity (HR = 0.64), current smoking (HR = 2.04), and depressive symptoms (HR = 1.36) remained significant predictors. Interventions should be designed to minimize transition by managing smoking and depressive symptoms. Further research is required for associations between obesity and clinical progression to test the hypothesis of obesity paradox. [ Journal of Gerontological Nursing, 46 (8), 28–36.]

Physical frailty is one of the fundamental hallmarks of aging. Older adults with mild cognitive impairment (MCI) are more likely to exhibit some characteristics of physical frailty such as worse gait and/or balance. Gait and/or balance disturbances may precede cognitive decline among cognitively healthy older adults. The purpose of this longitudinal observational study was to identify the temporal relationship between gait and/or balance disturbances and the onset of Alzheimer’s disease (AD) because it has not been well characterized among older adults with MCI. Data of 2,692 older adults with MCI (ages 74.5 ± 7.1 years, women making up 47% of the sample) were from the National Alzheimer’s Coordinating Center’s Uniform Data Set. Risk of incident AD by baseline gait and/or balance disturbances was examined by Cox regression models over 4.0 ± 3.0 years, adjusting for demographic characteristics, medical conditions, and study site where the data were collected. The presence of gait and/or balance disturbances predicted 38% to 55% (hazard ratios [HR] 1.38 to 1.55) increased risk of AD. Findings remained robust in sub-group analyses by sex and there were no noticeable changes compared with the original analyses. Thus, regardless of sex, gait and/or balance disturbances predicted the onset of AD among older adults with MCI. Health care providers may need to (1) catch a warning of possible cognitive decline by a frequent assessment of gait and/or balance disturbances and (2) provide effective strategies to improve gait and/or balance disturbances to potentially delay the onset of AD.

Racial disparities between multimorbidity presence and healthcare utilization are present within the United States, but less is known about the relationship between multimorbidity presence and healthcare utilization among Black Americans. This study was conducted to examine the relationship between multimorbidity and healthcare utilization among Black Americans.Cross-sectional study.This study (n = 425, 57% female) used adult level data from the 2012-2013 Connecticut Health Care Survey.Multivariate logistic regressions indicated that multimorbidity presence predicted a doctor and a specialist visit, but not a dentist visit.This study identified multimorbidity presence as a predictor for healthcare utilization, but further research is necessary to understand healthcare utilization experiences among Black Americans with multimorbidity to assess the quality of care. Appropriate measures should also be considered to increase access to dental care for Black Americans with multimorbidity.

Prevention is a priority in the absence of a cure for dementia. Physical activity and a neuroprotective diet such as the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet are healthy lifestyle behaviors that may slow the onset of dementia. However, research on the relationship between the combination of physical activity and the MIND diet and cognition is rare.The purpose of this study was to investigate whether the combination of high-intensity physical activity and the MIND diet is associated with better cognition compared with either behavior alone or neither behavior.A population-based, cross-sectional study was conducted using data from the Health and Retirement Study.Using information from a total of 3463 participants (age 68.0 ± 10.0 years), multivariate linear regression models and binary logistic regression models with interaction terms between high-intensity physical activity (PA) and the MIND diet (MIND) were used to assess associations of PA and MIND with global cognition and odds of cognitive decline. Group comparisons were conducted among four groups: PA-/MIND-, PA+/MIND-, PA-/MIND+, and PA+/MIND+.PA+/MIND- did not predict cognitive outcomes (versus PA-/MIND-). PA-/MIND+ was associated with better global cognition (mean difference [d] = 0.81; 95% confidence interval [CI] = 0.50-1.11; p 0.001) and lower odds of cognitive decline (odds ratio [OR] = 0.68; 95% CI = 0.54-0.86; p = 0.001) (versus PA-/MIND-). PA+/MIND+ predicted better global cognition (d = 0.98; 95% CI = 0.59-1.36; p 0.001) and lower odds of cognitive decline (OR = 0.69; 95% CI = 0.50-0.94; p = 0.004) (versus PA-/MIND-). PA+/MIND+ was associated with better global cognition (d = 0.60; 95% CI = 0.08-1.12; p 0.001), but did not predict lower odds of cognitive decline (versus PA+/MIND-). PA+/MIND+ did not predict cognitive outcomes (versus PA-/MIND+).Combining high-intensity physical activity and the MIND diet was associated with better cognitive health than high-intensity physical activity alone or non-adherence to both behaviors. To potentially exert additive effects, it will be important to encourage these two healthy habits. More research on the role of combined physical activity and dietary change is necessary to further inform policy and clinical guidance.

Episodic memory is affected early in the neuropathological process of Alzheimer's dementia. This study was performed to identify longitudinal associations between baseline vascular/neuropsychiatric risk factors and episodic memory changes over 4.1 ± 2.4 years in 1,401 older adults with subjective cognitive decline (age 74.0 ± 8.2 years). Data were from the National Alzheimer's Coordinating Center-Uniform Data Set and linear mixed effects regression models were used. Reference was those without risk factors. Participants with hypercholesterolemia and with former cigarette smoking had higher episodic memory scores, but current smokers had fewer points than reference at their first and follow-up visits. Despite no difference at baseline, episodic memory scores decreased in those with depressive symptoms relative to reference over time. In older adults with subjective cognitive decline, interventions managing current smoking and depressive symptoms could preserve episodic memory, which may result in delaying the onset of Alzheimer's dementia. Further research is required for the role of cholesterol and smoking.

Adults with chronic disease may experience uncertainty and depression when coping with their illness. This study identifies degrees of uncertainty and depression, as well as factors associated with depression in people with Parkinson's disease. The 120 participants included patients who visited the neurology outpatient department of a tertiary hospital in Seoul and individuals who attended public events managed by the Korean Parkinson's Disease Association. The mean age of the sample was 65.01 and 50.8% of patients were men. The mean scores of uncertainty and depression, measured using the Mishel Uncertainty in Illness Scale and Short Form Geriatric Depression Scale were 99.03 and 6.73, respectively. Approximately 68% of participants scored above the cut-off score for depression. Multiple regression analyses showed that uncertainty, perceived health status, and fatigue were factors significantly associated with depression. Nurses should be aware of and address these factors and their effects in order to implement interventions to prevent depression in people with Parkinson's disease.

This paper is the result of a research conducted for "Knowledge Resource Development by Excavation and preservation and DB Establishment of Traditional Home Remedy", a part of Korean Medicine knowledge infrastructure establishment and Korean Medicine therapy development project executed by Korea Institute of Oriental Medicine. This paper is a part of the plans to standardize Korean acupuncture and moxibustion and surgical techniques in order to make new techniques derived from Korean traditional medicine patentable, as presented in the Nagoya Protocol. By first reviewing traditional text sources and classifying them into index literature and index techniques, we can see a mutual relationship between these two categories. Based on current research papers, this study has established a total of 121 pieces of index literature as well as extracted 64 types of index techniques in acupuncture and surgery technique. Both index literature and index technique have been concurrently visualized in this paper in the "Korean Acupuncture & Moxibustion Technique and Surgical Manipulation Base Map".

Purpose : Local medicinal herb festivals present the history of the Korean medicine and cultural resources in the regions to play an important role in attracting tourists, vitalizing local economy, and improving the local image. Therefore, it is important to understand the origin of the festival and grasp historical and cultural meaning of local medicinal herb festivals. Methods : I compared the books and articles presented in the reference list. Results & Conclusions : Local medicinal herb festivals originates from traditional yangnyeongsi. Since the century, yangnyeongsi has grown up as a special market. Implementation of the Daedong Act promoted commodity and monetary economy that helped commerce and industry develop and market grow up. It also made changes in the social status system and yangnyeongsi has been such a historical phenomenon appeared in this social background. The growth of yangnyeongsi contributed to the progress in the private medicine that triggered the gradual transfer of power in the medicine to the private sector which has long been held by the government. In yangnyeongsi, there were many cultural events to attract visitors. It's the same case in China that preserves stages that were used for cultural events in the medicine market to pass down the historic sites while those in Korea are disappearing as yangnyeongsis are being pulled out of the city areas to the suburban areas due to the redevelopment projects. For this reason, restoration of the place for traditional yangnyeongsi should be taken into account through local medicinal herb festivals.

Korea Institute of Oriental MedicineObjectives : To investigate the progress, characteristics, and reasons of CV12 moxibustion that King Sukjong of Joseon Dynasty had experienced 31 years since 1684. Methods : This study mainly extracted the records and related records about CV12 moxibustion of King Sukjong and relevant records from Seungjeongwon Ilgi, and analyzed them. Aside from that, medical books wrote at that time and relevant records were additionally investigated.Results : King Sukjong cauterized CV12 or other CV12 related acupoints with moxa 21 years out of his 31 years from 1684 to 1714. The cautery period was usually between late January and mid February. He had 100 pieces of moxa for cautery. On the last day of his moxibustion, he cauterized ST36 with moxa. The moxibustion process consisted of the following steps: suggestion or requirement of moxibustion, decision of date and time, and moxa cautery. In 1684, the reason why King Sukjong cauterized CV12 with moxa was to treat his joint pain and nauseous symptoms. The effect can be found in Donguibogam, many other Korean medical books, and other general books at that time. In 1685, he began to cauterize CV12 with moxa to prevent diseases. Since then, most moxa cautery on CV12 had been performed in the same context.

Purpose The purpose of this study was to test the effects of group exercise and telephone counseling on physical and psychosocial health in people with Parkinson's disease (PD). Design This was a quasiexperimental study with a nonequivalent control group. Methods This study took place in Seoul, South Korea. Twenty-two and 20 subjects participated in the intervention and comparison groups, respectively. The intervention group performed group exercises twice a week and received motivational telephone counseling every 2 weeks for 12 weeks. Findings Significant effects of the intervention were found in overall health-related quality of life (HRQOL; p = .012) and in the following HRQOL dimensions: stigma (p = .026), social function (p = .003), cognition (p = .028), and communication (p = .014). No other variables such as activities of daily living, functional fitness, and depression exhibited statistically significant effects. Conclusion/clinical relevance These results indicate that group exercise with telephone counseling positively affects some aspects of HRQOL in PD patients.

Parkinson's disease is a neurodegenerative chronic condition with a declining trajectory and lack of a cure, making quality of life an important aspect of care. The purpose of this literature review was to analyze the state-of-the-science on the effects of non-pharmacological treatments on quality of life in person's with Parkinson's disease. Literature search was conducted using keywords in electronic databases up to September 1, 2016 and cross-searching the references of identified articles. Of the 259 articles generated, 26 met the eligibility criteria and were included in this review. The majority of studies (77%) were Level I evidence and 23% Level II evidence. The levels of study quality were: strong (50%), moderate (15%), and weak (35%). The interventions varied across studies with 15 studies evaluating a similar intervention. About 58% of the studies showed that the interventions improved quality of life. In conclusion, a variety of non-pharmacological interventions have been increasingly studied for their effects on quality of life in Parkinson's disease, showing initial promising results. However, most interventions were only examined by a limited number of studies and the minimal and optimal intervention doses needed for improving quality of life are yet unknown.

Interventions that grow patient capacity to do the work of health care and life are needed to support the health of cancer survivors. Health coaching may grow capacity. This systematic review of health coaching interventions explored coaching's ability to grow capacity of cancer survivors. The authors included randomized trials or quasi-experimental studies comparing coaching to alternative interventions, and adhered to PRISMA reporting guidelines. Data were analyzed using the Theory of Patient Capacity (BREWS: Capacity is affected by factors that influence ability to reframe Biography ["B"], mobilize or recruit Resources ["R"], interact with the Environment of care ["E"], accomplish Work ["W"]), and function Socially ["S"]). The authors reviewed 2210 references and selected 12 studies (6 randomized trials and 6 pre-post). These studies included 1038 cancer survivors, mean age 57.2 years, with various type of cancers: breast, colorectal, prostate, and lung. Health coaching was associated with improved quality of life, mood, and physical activity but not self-efficacy. Classified by potential to support growth in patient capacity, 67% of included studies reported statistically significant outcomes that support "B" (quality of life, acceptance, spirituality), 75% "R" (decreased fatigue, pain), 67% "W" (increased physical activity), and 33% "S" (social deprivation index). None addressed changing the patient's environment of care. In cancer survivors, health coaching improved quality of life and supported patient capacity by several mechanisms, suggesting an important role for "Capacity Coaching." Future interventions that improve self-efficacy and patients' environments of care are needed. Capacity Coaching may improve health and quality of life of cancer survivors.

Episodic memory is typically affected early in the process of Alzheimer’s disease. Little is known about factors affecting episodic memory in subjective cognitive decline (SCD). The purpose of this study was to identify vascular and neuropsychiatric risk factors associated with episodic memory changes in older adults with SCD. Using the National Alzheimer’s Coordinating Center-Uniform Data Set, the relationship between baseline modifiable risk factors and episodic memory changes was analyzed using linear mixed-effects regression models. The study included a total of 1,401 subjects with SCD (mean ages: 74.0±8.2 years, 67.5% females, 84.2% White, mean follow-up period: 4.1±2.4 years). In univariate adjusted model, statistically significant coefficients on main effect or interaction with time were selected and entered into multivariate model, which was adjusted mutually for chosen independent variables and for all covariates. Reference in the final model was subjects without 1) hypercholesterolemia, 2) cigarette smoking history, and 3) depression. Those with hypercholesterolemia and former smokers had 0.024 and 0.035 points higher episodic memory scores than reference at baseline with similar rate of score changes between each group and reference over time, respectively. Current smokers scored 0.081 points lower than reference at baseline with similar rate of change over time between groups. Despite no difference at baseline, the score of depressed subjects decreased by 0.014 points a year compared to reference. It is important to manage current smoking and depression for older adults with SCD. Further research needs to identify which levels of cholesterol and smoking have a protective effect on episodic memory.

Background Chronic conditions are increasingly more common and negatively impact quality of life, disability, morbidity, and mortality. Health coaching has emerged as a possible intervention to help individuals with chronic conditions adopt health supportive behaviors that improve both quality of life and health outcomes. Methods/design We planned a systematic review and meta-analysis of the contemporary health coaching literature published in the last decade to evaluate the effect of health coaching on clinically important, disease-specific, functional, and behavioral outcomes. We will include randomized controlled trials or quasi-experimental studies that compared health coaching to alternative interventions or usual care. To enable adoption of effective interventions, we aim to explore how the effect of intervention is modified by the intervention components, delivering personnel (i.e., health professionals vs trained lay or peer persons), dose, frequency, and setting. Analysis of intervention outcomes will be reported and classified using an existing theoretical framework, the Theory of Patient Capacity, to identify the areas of patients’ capacity to access and use healthcare and enact self-care where coaching may be an effective intervention. Discussion This systematic review and meta-analysis will identify and synthesize evidence to inform the practice of health coaching by providing evidence on components and characteristics of the intervention essential for success in individuals with chronic health conditions. Systematic review registration PROSPERO CRD42016039730 Electronic supplementary material The online version of this article (doi:10.1186/s13643-016-0316-3) contains supplementary material, which is available to authorized users.

Adults with chronic disease may experience uncertainty and depression when coping with their illness. This study identifies degrees of uncertainty and depression, as well as factors associated with depression in people with Parkinson's disease. The 120 participants included patients who visited the neurology outpatient department of a tertiary hospital in Seoul and individuals who attended public events managed by the Korean Parkinson's Disease Association. The mean age of the sample was 65.01 and 50.8% of patients were men. The mean scores of uncertainty and depression, measured using the Mishel Uncertainty in Illness Scale and Short Form Geriatric Depression Scale were 99.03 and 6.73, respectively. Approximately 68% of participants scored above the cut-off score for depression. Multiple regression analyses showed that uncertainty, perceived health status, and fatigue were factors significantly associated with depression. Nurses should be aware of and address these factors and their effects in order to implement interventions to prevent depression in people with Parkinson's disease.

Here we propose an image quality assessment (IQA) based on histogram of oriented gradients (HOG). This method makes use of the characteristic that the histogram of gradient image describes the state of input image. In the proposed method, the image quality is derived by the slope of the HOG obtained from the target image. The line representing the HOG is measured by a random sample consensus (RANSAC) on the HOG. Simulation results based on the LIVE image quality assessment database suggest that the proposed method aligns better with how the human visual system perceives image quality than several state-of-the-art IQAs.

The aim of this study is to look at how pepper was used in traditional medicine. In other words, this study aims to take a look at the process by which the medicinal nature & efficacy of pepper in traditional society was perceived and arranged through the aspects of the use of pepper as an exotic crop for treating diseases. This study investigated cases of using pepper for medical treatments by referring to books on traditional medicine in Korea. The old records about pepper are mainly in empirical medical books from the late Chosun dynasty. Nevertheless, the records about pepper tend to decrease in medical text as time goes by. Such a phenomenon can be attributable to the fact that people began to use pepper for daily food life rather than for medicinal purposes. Pepper was used mostly for digestive trouble such as vomiting, diarrhea, and stomachaches, and it was also applied to mental and aching diseases caused by the sound of body fluids remaining in the stomach. In addition, there were many cases where pepper was used externally for surgical disorders. Such symptoms for treatment are linked to, or in a complementary relationship with, research results in modern times. Boiled pepper was generally taken in the traditional herbal decoction method, and in the case of surgical diseases, it was applied externally. The cases of using old pepper, using pepper with seeds or without seeds, and using pepper mixed with sesame oil belong to a sort of herbal medicine processing, which usually aimed at changing the medicinal nature of pepper. In addition, in relation to the eating habits at that time, pepper was used as seasoning and to make red pepper paste with or without vinegar. There are two words used for pepper in the medical textbooks, 苦椒 (gocho) and 烈棗 (yeoljo). These words are translated into Korean as gochu, so we can identify this word as a nickname for pepper.

Background: Although traditional Korean medicine (TKM) has been influenced by traditional Chinese medicine (TCM), it has developed distinctive features. Around the tenth century, Chinese medical books were introduced to Korea. In those days, Koreans started movement to develop its own medical system. Methods: We reviewed Korean and Chinese medical literatures, and analysed the characteristics between two medical systems. Results: In the early 17th century, Dongeuibogam was published by Dr Joon Hur. He provided a turning point to establish Korean medical system independent from TCM. TKM emphasizes specific characteristics of the individual who suffered from the disease, rather than single symptom. The concept was elaborated by Dr Jae Ma Lee who published Dongeuisusaebowon in the early 20th century. Conclusion: Through historical development, TKM has established the unique characteristic and modality as the whole-person-centered medicine.

We evaluated the psychometric properties of the Korean version of the Self-Efficacy for Exercise Scale (SEE-K). The SEE-K consists of nine items and was translated into Korean using the forward-backward translation method. We administered it to 212 community-dwelling older adults along with measures of outcome expectation for exercise, quality of life, and physical activity. The validity was determined using confirmatory factor analysis and Rasch analysis with INFIT and OUTFIT statistics, which showed acceptable model fit. The concurrent validity was confirmed according to positive correlations between the SEE-K, outcome expectation for exercise, and quality of life. Furthermore, the high physical activity group had higher SEE-K scores. Finally, the reliability of the SEE-K was deemed acceptable based on Cronbach's alpha, coefficients of determination, and person and item separation indices with reliability. Thus, the SEE-K appears to have satisfactory validity and reliability among older adults in South Korea.