Literacy and Cognitive Aging in the Elderly Korean Population

문맹은 저학력과 더불어 인지 노화 및 치매의 위험 요인으로 알려져 있으며, 뇌의 신경학적인 병리나 노화와 관련된 변화가 임상적으로 발현되는 것을 막거나 지연하는 뇌의 능력인 인지 자원(cognitive reserve)의 부족이 그 메커니즘으로 제안되고 있다. 본 연구에서는 문식성이 인지 노화에 미치는 영향을 조사하기 위해 인지 노화 종단 연구에 참여한 정상 노인들을 대상으로 분석을 실시하였다. 인지 수행에 미치는 연령의 영향이 문식성 여부에 따라 달라지는지를 확인하기 위하여 연령과 문식성의 상호작용 효과를 분석하였고, 재검사 시 문맹 노인들에게서 인지 기능 감퇴 위험이 더 높은지를 확인하기 위해 로지스틱 회귀분석을 실시하였다. 인지 기능 감퇴자는 표준화된 회귀 기반 모델(SRB)을 사용하여 재검사시 연습 효과, 평균으로의 회귀의 영향을 통제한 후 측정 오차를 반영한 신뢰구간을 고려하여 선별하였다. 본 연구 결과, 문식성은 정상 노인들의 인지 수행 및 인지 노화에 영향을 미치는 중요한 변인인 것으로 나타났다. 첫째, 문맹 노인들은 문해 노인들에 비해 주의, 관리, 구성, 개념화, 기억 등 다양한 인지 기능 영역에서의 수행이 저조하였다. 둘째, 기저 검사에서 한국판 치매 평가 검사(K-DRS) 수행에 미치는 연령의 부적인 영향은 문맹 노인들에게서 더 크게 나타났다. 셋째, 재검사 시 인지 감퇴자의 비율은 문해 집단에 비해 문맹 집단에서 약 5배 정도 높았으며, 연령 및 교육, 성별을 통제한 후 승산비(OR)는 3.62였다. 본 연구의 결과는 문식성이 인지 자원의 형성과 관련되어 있으며, 글을 깨우치는 것만으로도 인지 노화 및 치매를 예방하는 데에 도움이 될 수 있음을 시사한다.

keywords: Illiteracy, Cognitive aging, Dementia, Longitudinal Study, Cognitive Reserve, K-DRS, 문맹, 인지 노화, 치매, 종단연구, 인지 자원, K-DRS

Abstract

Illiteracy as well as low education are known risk factors of developing dementia. Lack of reserve has been suggested as a possible mechanism underlying increased risk for dementia in this population. We believe that the same mechanism, or reserve, would be related to normal cognitive aging. This study was conducted to examine whether illiteracy moderated the patten of age-related cognitive change and was related to increased risk for cognitive decline in follow-up tests in normal Korean elderly subjects. Standardized Regression Based(SRB) Model was utilized to detect cognitive decliner controlling regression to mean, practice effect and measurement error. The main results were as follows. First, the illiterate performed poorly on all area of cognitive function including attention, initiation/perseveration, construction, conceptualization and memory than the literate. Second, age-related cognitive change was faster in the illiterate than the literate in all cognitive areas in cross-sectional analysis. Third, the rate of cognitive decliner was about five times higher in the illiterate than the literate group, and the odds ratio of the illiterate was 3.62. These results suggested that lack of reserve, measured by literacy, may have negative influence on normal cognitive aging as well as dementia. Acquiring literacy could prevent cognitive aging and dementia.

keywords: Illiteracy, Cognitive aging, Dementia, Longitudinal Study, Cognitive Reserve, K-DRS, 문맹, 인지 노화, 치매, 종단연구, 인지 자원, K-DRS

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논문 상세

Vol.35 No.3

한국 노인의 문식성과 인지 노화

Literacy and Cognitive Aging in the Elderly Korean Population

초록

Abstract

참고문헌

한국심리학회지: 일반