Application of a cognitive program with a comprehensive strategy feedback for Korean older adults.

This study assesses the effect of a cognitive program with a comprehensive strategy feedback on the cognitive function and memory self-efficacy of community-dwelling older adults and explores its applicability in Korea. The study employed a group pre-posttest design on 10 cognitively normal older participants. The four-week cognitive program involved daily completion of cognitive tasks at home using CoTras-Pro 2 and remotely provided individual non-face-to-face feedback. Additionally, biweekly face-to-face group feedback sessions were conducted with five participants. The Korean version of the Montreal Cognitive Assessment, the Korean-Color Word Stroop Test, and the Memory Self-Efficacy Questionnaire were used. Post-interviews were conducted to collect feedback. The program exerted a notable positive impact on cognitive function and memory self-efficacy. A study designed as a large-scale program conducted in collaboration with community-based public and private organizations holds the potential to be modeled for similar intervention programs involving a large number of participants.

Demonstration of the Yonsei-Social Play Evaluation Tool Keyforms for Occupational Therapy Practice.

Play is regarded as a child's primary occupation and provides valuable information about the child's abilities. Thus, informative assessment tools of play skills are critical for establishing play-related treatment goals in occupational therapy. The objective of this study is to present a practical method for occupational therapists to develop intervention goals using the Yonsei-Social Play Evaluation Tool (Y-SPET) keyforms. Parent responses (n = 310) for preschool children (three to six years old) who did not have a medical diagnosis were examined. The Rasch measurement model was used to create keyforms for the Y-SPET. All children's raw scores were converted into individual Rasch-calibrated logit scores and standard errors were estimated to establish logically attainable treatment goals. Results showed use of the keyforms could logically identify the intervention goals of the children's social play. This suggests that the Y-SPET keyforms are helpful for assessing the level of children's social play and establishing practical treatment goals.

Validity of a novel computerized screening test system for mild cognitive impairment.

ABSTRACTBackground:The mobile screening test system for screening mild cognitive impairment (mSTS-MCI) was developed for clinical use. However, the clinical usefulness of mSTS-MCI to detect elderly with MCI from those who are cognitively healthy has yet to be validated. Moreover, the comparability between this system and traditional screening tests for MCI has not been evaluated. OBJECTIVE: The purpose of this study was to examine the validity and reliability of the mSTS-MCI and confirm the cut-off scores to detect MCI. METHOD: The data were collected from 107 healthy elderly people and 74 elderly people with MCI. Concurrent validity was examined using the Korean version of Montreal Cognitive Assessment (MoCA-K) as a gold standard test, and test-retest reliability was investigated using 30 of the study participants at four-week intervals. The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were confirmed through Receiver Operating Characteristic (ROC) analysis, and the cut-off scores for elderly people with MCI were identified. RESULTS: Concurrent validity showed statistically significant correlations between the mSTS-MCI and MoCA-K and test-rests reliability indicated high correlation. As a result of screening predictability, the mSTS-MCI had a higher NPV than the MoCA-K. CONCLUSIONS: The mSTS-MCI was identified as a system with a high degree of validity and reliability. In addition, the mSTS-MCI showed high screening predictability, indicating it can be used in the clinical field as a screening test system for mild cognitive impairment.

Item-level psychometrics of the ADL instrument of the Korean National Survey on persons with physical disabilities.

PURPOSE: The aim of this study is to investigate the psychometrics of the 12 items of an instrument assessing activities of daily living (ADL) using an item response theory model. METHODS: A total of 648 adults with physical disabilities and having difficulties in ADLs were retrieved from the 2014 Korean National Survey on People with Disabilities. The psychometric testing included factor analysis, internal consistency, precision, and differential item functioning (DIF) across categories including sex, older age, marital status, and physical impairment area. RESULTS: The sample had a mean age of 69.7 years old (SD = 13.7). The majority of the sample had lower extremity impairments (62.0%) and had at least 2.1 chronic conditions. The instrument demonstrated unidimensional construct and good internal consistency (Cronbach's alpha = 0.95). The instrument precisely estimated person measures within a wide range of theta values (-2.22 logits < Î¸ < 0.27 logits) with a reliability of 0.9. Only the changing position item demonstrated misfit (χ2 = 36.6, df = 17, p = 0.0038), and the dressing item demonstrated DIF on the impairment type (upper extremity/others, McFadden's Pseudo R 2 > 5.0%). CONCLUSIONS: Our findings indicate that the dressing item would need to be modified to improve its psychometrics. Overall, the ADL instrument demonstrates good psychometrics, and thus, it may be used as a standardized instrument for measuring disability in rehabilitation contexts. However, the findings are limited to adults with physical disabilities. Future studies should replicate psychometric testing for survey respondents with other disorders and for children.

Effectiveness of community-based interventions for older adults living alone: a systematic review and meta-analysis.

OBJECTIVES: This study examined the effectiveness of community-based interventions designed for older adults living alone through a systematic review and meta-analysis. METHODS: The study incorporated 4 randomized controlled trials (RCTs) and 5 non-RCTs to evaluate various interventions. The methodological quality of these studies was assessed using the Downs and Black checklist, while Q-statistic and I-square tests were performed to examine statistical heterogeneity. Additionally, visual inspection of funnel plots and the trim-and-fill method were employed to investigate potential publication bias. Of the 2,729 identified studies, 9 met the criteria for inclusion in this review. Independent variables were categorized into 5 groups (physical activity, nutrition, social relationships, social participation, and combined intervention) to examine their effects. Dependent variables were similarly classified into 5 subgroups to identify the specific effects of the interventions. RESULTS: Interventions focusing on nutrition and combined approaches were the most effective, yielding effect sizes of 0.96 (95% confidence interval [CI], 0.66 to 1.25) and 0.43 (95% CI, 0.26 to 0.60), respectively. The interventions had the greatest impacts on the health behavior and mental health of the participants, with effect sizes of 0.98 (95% CI, 0.73 to 1.22) for health behavior and 0.67 (95% CI, 0.19 to 1.16) for mental health. CONCLUSIONS: This study suggests a direction for the development of community-based interventions tailored to the needs of older adults living alone. Additionally, it provides evidence to inform policy decisions concerning this demographic.

Social Network Typologies and Digital Literacy Differences among Korean Older Adults: A Latent Class Analysis.

BACKGROUND: This study categorized older Korean adults' social networks and analyzed their characteristics and digital literacy differences based on type. METHODS: We analyzed data from 9,377 Korean older adult participants of the 2020 National Survey of Older Koreans, and performed latent class analysis (LCA) chi-square and Welch's F analyses to understand the characteristics of each social network type. The Games-Howell post-hoc test was applied to determine the significance of differences between groups. RESULTS: The three social network types derived using LCA were "child-centered," "child-friend," and "friend-centered." The digital literacy levels differed significantly according to social network type. CONCLUSION: The results of this study can be used to propose intervention programs and services associated with older adults' social networks by examining their social network types and the corresponding differences in digital literacy.

Longitudinal Changes in Dual Decline in Memory and Gait Speed Association with Instrumental Activities of Daily Living: Findings from the National Social Life, Health, and Aging Project.

Objective: We investigated the association between dual decline (DD) (loss of memory and gait speed) and the instrumental activities of daily living (IADL) degeneration in older adults. Methods: Data were drawn from the National Social Life, Health, and Aging Project (NSHAP) reflecting changes over 5 years. This study used the NSHAP data set wave 2 (2010-2011, N = 3196) and wave 3 (2015-2016, N = 4377). Results: Data from 1640 participants were retrieved. There were 601 people with DD and 1039 people without-DD. The DD group had a 28.4% (95% CI = 1.013-1.626) greater risk of degrading in IADL than the without-DD group (odds ratio = 1.284, p < .05). Conclusion: Current research can be used when establishing intervention programs or policies that can prevent IADL degradation through simple memory training and walking activities for older adults living in the community.

Development of Leisure Valuation Assessment Tool for the Elderly.

This study aimed to develop a leisure valuation assessment tool to revitalize leisure activities for the elderly living in the community. The research method, literature review, and Delphi survey were conducted for the expert panel. Then, the leisure value and participatory leisure activity items were derived to form the assessment items. The two Delphi surveys revealed 38 leisure value assessment items and 41 participating leisure activity items. We attempted to verify the model suitability and validity of the leisure value assessment items through confirmatory factor analysis. The verification showed a good fit. Based on the intensive validity test result, AVE (average variance extracted) values were 66 for physical leisure activities, 65 for emotional leisure activities, and 65 for social leisure activities. The conceptual reliability was 0.96 for physical leisure activities, 0.95 for emotional leisure activities, and 0.96 for social leisure activities. Regarding the internal consistency for reliability verification, Cronbach's alpha values for physical leisure, emotional leisure, and social leisure activities were 0.909, 0.925, and 0.955, respectively. Hence, the items were highly interrelated and homogeneous tests that measured the same characteristics. The assessment tool can be used to identify useful information on the leisure activities of the elderly and to activate leisure activities for the elderly.

Development of a Social Play Evaluation Tool for Preschool Children.

Play has been used as an intervention or evaluation tool for children. Developing a social play evaluation tool can provide clinical criteria for intervening in social play. We aimed to develop a social play evaluation tool for preschool children based on Parten's stages of development. We tested the construct validity of the scale using confirmatory factor analysis and Rasch analysis, and the known-groups validity by examining the Rasch-calibrated mean score differences across age groups. A total of 40 preliminary items-17 items for associative play and 23 items for cooperative play-were examined. There were significant differences in the scores for associative play between ages 3 and 6 (F = 2.65, p = 0.049), and for cooperative play between ages 3 and 5, 3 and 6, and 4 and 6 (F = 10.44, p < 0.0001). The findings could contribute to subsequent development and validation of occupational therapy programs on play.

The Effects of Occupation-Based Community Rehabilitation for Improving Activities of Daily Living and Health-Related Quality of Life of People with Disabilities after Stroke Living at Home: A Single Subject Design.

Objective: The aim of this study is to investigate the effect of occupation-based community rehabilitation on activity daily of living and health-related quality of life of people with disabilities after stroke at home. Method: In this study of three people with disabilities after stroke living at home, A-B-A single-subject design was used. The occupation-based community rehabilitation was implemented during the intervention phase. It included task oriented and feedback, related information education, home environment modification, and community resource network. After applying the intervention, changes in activities of daily living and health-related quality of life were evaluated by the Modified Barthel Index (MBI), the EuroQol-5 dimension (EQ-5D), and the Assessment of Motor and Process Skills (AMPS). Result: After applying the occupation-based community rehabilitation program, all three participants' daily life activities and quality of life improved. In addition, the occupational performance skills in all participants were maintained. Conclusion: It was confirmed that individual occupational-based community rehabilitation had a positive effect on the activities of daily living and quality of life improvement of the people with disabilities after stroke at home.

Item-level psychometrics of the Ascertain Dementia Eight-Item Informant Questionnaire.

The aim of this study is to evaluate the item-level psychometrics of the Ascertain Dementia Eight-Item Informant Questionnaire (AD-8) by examining its dimensionality, rating scale integrity, item fit statistics, item difficulty hierarchy, item-person match, and precision. We used confirmatory factor analysis and the Rasch rating scale model for analyzing the data extracted from the proxy versions of the 2019 and 2020 National Health and Aging Trends Study, USA. A total of 403 participants were included in the analysis. The confirmatory factor analysis with a 1-factor model using the robust weighted least squares (WLSMV) estimator indicated a unidimensional measurement structure (χ2 = 41.015, df = 20, p = 0.004; root mean square error of approximation = 0.051; comparative fit index = 0.995; Tucker-Lewis Index = 0.993;). The findings indicated that the AD-8 has no misfitting items and no differential item functioning across sex and gender. The items were evenly distributed in the item difficulty rating (range: -2.30 to 0.98 logits). While there were floor effects, the AD-8 revealed good reliability (Rasch person reliability = 0.67, Cronbach's alpha = 0.89). The Rasch analysis reveals that the AD-8 has excellent psychometric properties that can be used as a screening assessment tool in clinical settings allowing clinicians to measure dementia both quickly and efficiently. To summarize, the AD-8 could be a useful primary screening tool to be used with additional diagnostic testing, if the patient is accompanied by a reliable informant.

Developing Domains and Items about Self-Management among Elderly People with Chronic Disease.

Lifestyle is considered as a key factor that affects one's health and quality of life, and it has become the focus of increasing research interest worldwide. OBJECTIVES: We aimed to determine the areas of self-management necessary as part of occupational therapy for elderly people suffering from chronic diseases living in local communities, as well as elements to be included in each area. METHOD: Delphi survey methodology was utilized. Participants answered three surveys, and we derived the mean, standard deviation, and content validity ratios for each domain and item. RESULTS: We derived 13 domains and 68 items about self-management, derived the fit and importance of 1 domain and 23 items, and finally derived 12 domains and 54 items. CONCLUSION: The program developed using this research can become a systematic and evidence-based intervention and provide an opportunity for self-management to the target population.

Theme Trends and Knowledge-Relationship in Lifestyle Research: A Bibliometric Analysis.

Healthy living habits (healthy eating, regular physical activity, abstinence from smoking, restrictions on alcohol consumption, and stress management) can help prevent a significant number of diseases. The purpose of this study is to use a bibliometric analysis to analyze the relationships between countries, institutions and authors through lifestyle studies from 2016 to 2020 to find out the latest research trends. This study utilized bibliometric data collected through Scopus including thesis titles, authors, agencies, countries/regions, publication years, and keywords. Data were analyzed using the VOS viewer (Vers. 1.6.13; Leiden University, Leiden, The Netherlands) and the findings were used to visualize similarity mapping techniques. Publication of lifestyle-related research papers has steadily increased between 2016 and 2020. The country/region most actively conducting such research was the United States, also home to the majority of institutions conducting work in the field. PloS ONE published the most lifestyle-related research under the field of Medicine. Identified keywords were related to risk measures, psychosocial factors, prevention, health promotion, and risk factors. Lifestyle research is a promising field of research worldwide and has great potential to improve human health, the environment, and quality of life. The findings are expected to promote future research and give direction to the advancement of the field of research by comprehensively analyzing and summarizing lifestyle research trends.

Reliability and Validity of the Korean Late-Life Function and Disability Instrument.

The purpose of this study was to develop the Korean version of the Late-Life Function and Disability Instrument (K-LLFDI) and verify its reliability and validity. Fifty community-dwelling older adults aged 65 years and above with independent mobility were surveyed. The reliability and validity of the instrument were verified. The overall cultural validity of 48 items was evaluated as very high (0.95), and only one item that was not appropriate was revised. The reliability of the remaining six domains was either high or very high. Internal consistency was high (α = 0.859) in the Disability component of the instrument and very high (α = 0.914) in the Function component. The factor loading for 42 out of 48 items was above 0.04. Overall, each component was well reflected by the sub-items. The K-LLFDI is expected to be instrumental in solving the rapidly growing problems of community-dwelling older adults.

Twelve Smartphone Applications for Health Management of Older Adults during the COVID-19 Pandemic.

This study investigated smartphone applications that may be helpful in managing the health of the elderly during COVID-19. The application searched the seven areas of health management, newly classified in OTPF 4th edition with keywords in the Google Play Store. As a result, two applications meeting the selection criteria were selected for each area. The selected applications are social and emotional health promotion and maintenance: Wysa & MindDoc, symptom and condition management: Ada & Diseases Dictionary, communication with the health care system: Telehealth & Blood Pressure Diary, medication management: Medisafe & MyTherapy, physical activity: FitOn & Samsung Health, nutrition management: Lifesum & Health and Nutrition Guide. Through the analyzed applications, twelve applications with the potential to improve the health management and quality of life in older adults during social distancing or self-isolation due to COVID-19 were identified.

Analysis of Factors Affecting Depression in Older Adults in South Korea.

Objective: This study aimed to analyze the factors affecting depression among South Korean middle-aged and older adults using data from the Korean Longitudinal Study of Aging. Methods: We analyzed data regarding demographic characteristics, lifestyle, quality of life, cognitive level, and depression. Cognitive level and depression were evaluated using the Korean-Mini-Mental Status Examination and Center for Epidemiological Studies Depression Scale, respectively. Results: Depression was correlated with age, gender, residential area, level of education, alcohol intake, regular exercise, life satisfaction, and cognitive level, but not smoking. Furthermore, depression was highly affected by age, residential area, regular exercise, life satisfaction, and cognitive level, with a prediction accuracy of 80.26% achieved through machine learning analysis. Conclusions: Various factors are associated with depression in middle-aged and older adults. Therefore, multifaceted interventions for preventing depression in these age groups are required.

Effect of Transcranial Direct Current Stimulation Combined with Rehabilitation on Arm and Hand Function in Stroke Patients: A Systematic Review and Meta-Analysis.

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that may enhance motor recovery after stroke. We performed a systematic review and meta-analysis to assess the efficacy of tDCS combined with rehabilitation on arm and hand function after stroke. Electronic databases were searched from their inception to September 2021. We performed a systematic review of selected randomized controlled trials, and methodological qualities were measured using the PEDro (Physiotherapy Evidence Database) scale. We calculated the standardized mean difference for effect size using the Comprehensive Meta-Analysis 3.0 software. We selected 28 studies for the systematic review and 20 studies for the meta-analysis. The overall effect size was 0.480 (95% CI [0.307; 0.653], p < 0.05), indicating a moderate effect size of tDCS combined with rehabilitation for upper extremity function in stroke survivors. The tDCS with occupational therapy/physical therapy (0.696; 95% CI [0.390; 1.003], p < 0.05) or virtual reality therapy (0.510; 95% CI [0.111; 0.909], p < 0.05) was also significantly more effective than other treatments. This meta-analysis of 20 randomized controlled trials provides further evidence that tDCS combined with rehabilitation, especially occupational therapy/physical therapy and virtual reality therapy, may benefit upper extremity function of the paretic upper limb in stroke patients.

Impact of Family-Centered Early Intervention in Infants with Autism Spectrum Disorder: A Single-Subject Design.

OBJECTIVE: Autism spectrum disorder is a neurodevelopmental disorder that affects communication, social skills, and behavior and can present in early childhood. The present study is aimed at investigating the effects of family-centered early intervention on the quality of social interaction and social interaction skills in infants with suspected autism spectrum disorder using a single-subject design. METHOD: As a single-subject design study, evaluations were conducted at baseline phase A, intervention phase B, baseline phase A', and follow-up phase. The family-centered early intervention program was implemented during the intervention phase. Family-centered early intervention programs included home environmental modification, play video recording and training, task and feedback, related information training, and question and answer. The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up and Evaluation of Social Interaction was used for evaluation. RESULT: Three participants completed the study. After applying the family-centered early intervention program, the quality of social interaction and social interaction skills of all participants improved. In addition, the risk of autism spectrum disorder in all participants was reduced. CONCLUSION: Family-centered early intervention was confirmed to have a positive effect on the improvement of social interaction skills in infants with suspected autism spectrum disorder.

Effects of a Cognitive-Functional Intervention Method on Improving Executive Function and Self-Directed Learning in School-Aged Children with Attention Deficit Hyperactivity Disorder: A Single-Subject Design Study.

BACKGROUND: School-aged children with attention deficit hyperactivity disorder (ADHD) face many difficulties with self-directed learning because of their poor executive function. This leads to secondary problems such as learning disabilities and depression, so the role of intervention to improve executive function in school-aged children with ADHD is important. OBJECTIVE: The present study is aimed to investigate how cognitive-functional (Cog-Fun) intervention affected executive function of school-aged children with ADHD and the sustainability of these effects. To investigate the effects of changes in the executive function of school-aged children with ADHD through Cog-Fun intervention in self-directed learning. METHOD: A single-subject A-B-A research design was employed in this study. Three children aged 9-10 years who were diagnosed with ADHD were selected. A total of 17 experimental sessions were conducted. The Cog-Fun intervention program was implemented during the intervention phase. To measure dependent variables, Behavior Rating Inventory of Executive Function (BRIEF) and Homework Problems Checklist (HPC) were used. Significant changes in executive function assessed by the Children's Color Trails Test (CCTT) and Stroop test were analyzed through two-standard deviation band analysis. Additionally, video clips of task performance were analyzed to examine qualitative performance changes in self-directed learning. RESULT: All three participants presented statistically significant changes with a number of near-misses of CCTT and color words score of Stroop test during the intervention. T-scores of the Global Executive Composite (GEC) decreased after the intervention, indicating improvement in executive function. The follow-up period revealed retention of the improved executive function. Additionally, self-directed learning improved in all participants after the implementation Cog-Fun intervention. CONCLUSION: The study supports the effectiveness of Cog-Fun intervention in improving executive function in school-aged children with ADHD and confirmed that the improvement of executive function ultimately leads to the improvement of self-directed learning performance.

Identifying Risk of Depressive Symptoms in Adults With Physical Disabilities Receiving Rehabilitation Services: Propensity Score Approaches.

OBJECTIVE: To compare the risk of depressive symptoms in adults with physical disabilities between rehabilitationreceivers and non-receivers. METHODS: A total of 3,568 adults with physical disabilities were retrieved from the 2014 Korean National Survey on People with Disabilities database. Four covariate adjustment methods (a multivariable regression model, inverse probability of treatment weighting [IPTW] adjusted for normalized weight, IPTW with stabilized weight, and greedy algorithm with 1:1 propensity score matching) were used to estimate the odds of having depressive symptoms. The dependent variable was depressive symptoms and the independent variable was the use of rehabilitation services. Baseline covariates were 19 demographic variables and 10 chronic condition variables. RESULTS: The four covariate adjustment methods revealed that adults with physical disabilities receiving rehabilitation services had a higher risk of depressive symptoms than those who did not receive these services (adjusted odds ratio, 1.191-1.294). CONCLUSION: Our findings suggest that adults with physical disabilities receiving rehabilitation services have higher risk of developing depressive symptoms. Therefore, rehabilitation professionals need to pay attention to depressive symptoms and establish therapeutic strategies that can reduce such risk in rehabilitation settings.