인지기능과 도구적인 일상생활기능의 관계에서 인구통계학적 변인들의 조절효과
Moderating Effects of Demographic Variables on the Relationship Between Cognitive Functions and Instrumental Activities of Daily Living
장승민 (성균관대학교)
강연욱 (한림대학교)
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초록
인지기능과 도구적인 일상생활기능은 경도인지장애와 치매를 변별하는데 있어 중요한 두 변인이다. 인지기능 수준과 도구적인 일상생활기능의 관계에 관해서는 일관적이지 않은 연구 결과가 보고되고 있는데 이는 연구에 포함된 대상 집단의 인구통계학적 특성이 다르기 때문인 것으로 사료된다. 본 연구는 인구통계학적 변인들이 인지기능 수준과 도구적인 일상생활기능의 관계에서 어떤 조절효과를 지니는지 탐색하기 위해서 수행되었다. 기억성 경도인지장애 환자 167명과 알츠하이머형 치매 환자 82명이 연구에 참여하였으며 전반적인 인지기능과 도구적인 일상생활기능을 평가하기 위해서 한국판 간이정신상태검사(K-MMSE)와 서울신경심리검사 2판(SNSB-II)을 개인검사로 환자에게 실시하였고 한국판 도구적인 일상생활기능척도(K-IADL)를 환자의 보호자에게 실시하였다. K-MMSE 점수와 SNSB-II에서 산출된 주의집중능력, 언어기능, 시공간기능, 기억력 및 전두엽/집행기능과 같은 5개의 인지영역 점수를 예측변인, K-IADL 점수를 준거변인, 인구통계학적 변인들(나이, 성별, 교육년수)을 조절변인으로 선정하고 위계적 회귀분석을 통해서 조절효과를 검증하였다. 그 결과 나이는 K-MMSE, 언어기능, 시공간기능, 기억력 및 전두엽/집행기능이 도구적인 일상생활기능에 미치는 영향을 조절하는 것으로 나타났고, 교육년수는 K-MMSE가 도구적인 일상생활기능에 미치는 영향을 조절하는 것으로 확인되었으나 성별의 조절효과는 발견되지 않았다. 이 결과는 경도인지장애와 알츠하이머형 치매 집단에서 나이와 교육년수가 인지기능이 도구적인 일상생활기능에 미치는 영향을 조절하고, 특히 나이의 조절효과가 크다는 사실을 시사한다.
- keywords
- demographic variables, cognitive functions, instrumental activities of daily living, moderation effect, 인구통계학적 변인, 인지기능, 도구적인 일상생활기능, 조절효과
Abstract
Cognitive functions and instrumental activities of daily living (ADL) are two crucial variables in distinguishing between mild cognitive impairment (MCI) and dementia. Inconsistent research findings have been reported in terms of the relationship between cognitive functions and instrumental ADL, which may be due to the different demographic characteristics of the subjects. The purpose of this study was to explore the moderating effect of demographic variables in the relationship between cognitive functions and instrumental ADL in patients with amnestic multi-domain MCI (amMCI, n=167) and dementia of the Alzheimer’s type (DAT, n=82). To evaluate the global cognitive ability, the Korean-Mini Mental State Examination (K-MMSE) and Seoul Neuropsychological Screening Battery 2nd Edition (SNSB-II) were administered to the patients as individual tests. The caregivers completed the Korean-Instrumental Activities of Daily Living (K-IADL) Scale. The K-MMSE and the five cognitive domain scores derived from SNSB-II such as attention, language, visuospatial function, memory, and frontal/executive function were used as predictor variables, the score of K-IADL as a criterion variable, and the demographic variables (age, sex, and years of education) as moderator variables. The moderating effect was verified by the hierarchical regression analysis. The results showed that age had a moderating effect on the relationship between K-MMSE, language, visuospatial function, memory, and frontal/executive function scores and instrumental ADL. Years of education had a moderating effect on the influence of K-MMSE on instrumental ADL, but no moderating effect was found in sex. The results imply that age and years of education in the MCI and DAT groups moderate the impact of cognitive functions on instrumental ADL, and age especially has a greater moderating effect.
- keywords
- demographic variables, cognitive functions, instrumental activities of daily living, moderation effect, 인구통계학적 변인, 인지기능, 도구적인 일상생활기능, 조절효과
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