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Original Article

Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

Younhee Kang1, Sun A Whang2, Kuemju Park3
Korean Journal of Adult Nursing 2015;27(6):656-664.
Published online: December 31, 2015

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Corresponding author: Kang, Younhee Division of Nursing, College of Health Sciences, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-4483, Fax: +82-2-3277-2850, E-mail: yxk12@ewha.ac.kr
• Received: August 31, 2015   • Accepted: December 12, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purposes of this study were to identify the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) among the community-dwelling elderly and to determine if there were differences in cognitive function, leisure activities, and exercises between the group with MCI-maintained and the group with reversion to NC.
  • Methods
    This study utilized a longitudinal descriptive comparative design. A total of 346 subjects over age 65 was recruited from public health center at baseline. Finally 152 elderly were enrolled at 1 year follow-up. Data were collected through MoCA-K, K-MMSE, KDSQ-C5 and questionnaires on leisure activities and exercises. Data were analyzed by IBM SPSS Statistics 21.0 using descriptive statistics, x2 test, and t-test.
  • Results
    The rate of reversion from MCI to NC among the subjects was 44.1%. At baseline, the group with MCI-maintained had lower cognitive function than the group with reversion to NC. At 1 year follow-up, the group with reversion to NC had higher subjective cognitive function than the group with MCI-maintained. Regarding leisure activities, there were differences between the groups at baseline and 1 year follow-up.
  • Conclusion
    It is suggested that age, education year, subjective cognitive function, and leisure activities should be considered at planning a nursing intervention for MCI.
  • Key Words: Mild cognitive impairment; Leisure activity; Exercise
Table 1.
MET (Metabolic Equivalent)
METs Types of exercise
2.5 Billiards
3 Bowling, gate ball, dumbbell
3.5 Hang glider
4 Walking, golf, yoga, hypogastric breathing
4.5 Weight lifting, table tennis, canoe, badminton, volleyball, horse-riding
5 Basketball, survival game, headstand, dodge ball, baseball, horizontal bar exercise, dancing, freehand exercise
5.5 Bicycle riding, calisthenics, fitness, foot volleyball, aerobics
6 Kendo, swimming, fencing, water-skiing, hula hoop
7 Football, tennis, ice skating, running, jogging, soccer, roller skating
8 Push-up, boxing, judo, teukgongmoosool, hiking, handball, karate, sit-up, ssireum, kung fu, wrestling, climbing stairs, hapkido
10 Kickboxing, martial arts, jump rope, taekwondo
12 Squash
Table2.
RateofNCGroupwith Reversionto NC, Groupwith MCI Maintained and Group with Progress to Dementia (N=152)
Groups n(%)
Group with reversion to NC 67(44.1)
Group with MCI maintained 81(53.3)
Group with progress to dementia 4(2.6)

NC=normal cognition; MCI=mild cognitive impairment.

Table3.
Comparisonsof General CharacteristicsbetweenGroupwith Reversionto NCandGroupwith MCI Maintainedat Base (N=148)
Characteristics Categories Group with reversion to NC (n=67) Group with MCI maintained (n=81) x2 or t p
n (%) or M±SD n (%) or M±SD
Gender Male 18 (26.9) 21 (25.9) 0.02 .522
Female 49 (73.1) 60 (74.1)
Age (year)   71.9±5.5 74.9±5.7 -3.31 .001
65~74 48 (71.6) 38 (46.9) - -
75~84 19 (28.4) 37 (45.7)
85 ≥   6 (7.4)
Education years   8.70±4.71 5.02±4.74 4.71 .001 ＜
0~5 11 (16.4) 41 (50.6) 18.94 .001 ＜
6~8 22 (32.8) 17 (21.0)
9~11 14 (20.9) 9 (11.1)
12 ≥ 20 (29.9) 14 (17.3)
Marital status With spouse 40 (59.7) 36 (44.4) 3.42 .071
Without spouse 27 (40.3) 45 (55.6)

NC=normal cognition; MCI=mild cognitive impairment.

Table 4.
Comparison of Cognitive Function, Leisure Activity and Exercise between the Group with Reversion to NC and the Group with MCI Maintained (N=148)
Characteristics Categories Group with reversion to NC (n=67) Group with MCI maintained (n=81) t p
M±SD M±SD
Objective cognitive function (MoCA-K) Baseline 20.60±1.61 17.65±3.41 6.89 .001 ＜
1 year F/U 25.12±1.68 18.60±3.32 15.43 .001 ＜
Subjective cognitive function (KDSQ-C5) Baseline 2.78±2.04 3.46±2.55 -1.77 .080
1 year F/U 2.01±1.94 2.96±2.30 -2.72 .007
Leisure activity (times/year) Baseline 793.67±372.41 666.91±343.35 2.15 .033
Watching TV 329.57±103.29 334.73±97.78
Listening radio 105.57±160.74 75.44±136.46
Reading newspapers 165.75±165.91 101.24±152.98
Reading books 138.58±157.71 95.10±143.13
Playing games 30.31±69.71 38.65±101.37
Participating cultural class 14.57±33.58 15.24±43.53
Others 9.33±50.24 6.5±42.13
1 year F/U 812.04±319.38 678.80±271.21 2.75 .007
Watching TV 357.99±41.30 362.74±20.33
Listening radio 97.57±154.95 51.09±125.60
Reading newspapers 149.52±170.19 100.94±156.65
Reading books 116.80±156.34 117.49±160.78
Playing games 30.86±87.44 33.44±95.99
Participating cultural class 29.10±75.53 6.81±20.72
Others 30.21±94.80 6.30±20.93
Exercise (Kcal/week) Baseline 926.20±1,230.57 889.90±1,253.03 0.18 .860
3 MET 5 ≤ ＜ 1,037.63±725.72 1,058.97±605.02
5 MET 7 ≤ ＜ 1,257.30±809.61 1,288.14±738.98
7 MET ≤ 1,598.29±1,009.36 2,601.46±2,148.50
1 year F/U 925.64±1,186.95 815.00±1,284.12 0.54 .590
3 MET 5 ≤ ＜ 1,104.29±675.55 1,032.27±594.38
5 MET 7 ≤ ＜ 916.14±785.60 1,167.92±836.62
7 MET ≤ 2,000.40±1028.63 3,941.33±2,505.23

NC=normal cognition; MCI=mild cognitive impairment; MET=metabolic equivalent.

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    Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study
    Korean J Adult Nurs. 2015;27(6):656-664.   Published online December 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.6.656
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    Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study
    Korean J Adult Nurs. 2015;27(6):656-664.   Published online December 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.6.656
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    Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study
    Reversion to Normal Cognition and Its Correlates among the Community-dwelling Elderly with Mild Cognitive Impairment: the Longitudinal Cohort Study

    MET (Metabolic Equivalent)

    METs Types of exercise
    2.5 Billiards
    3 Bowling, gate ball, dumbbell
    3.5 Hang glider
    4 Walking, golf, yoga, hypogastric breathing
    4.5 Weight lifting, table tennis, canoe, badminton, volleyball, horse-riding
    5 Basketball, survival game, headstand, dodge ball, baseball, horizontal bar exercise, dancing, freehand exercise
    5.5 Bicycle riding, calisthenics, fitness, foot volleyball, aerobics
    6 Kendo, swimming, fencing, water-skiing, hula hoop
    7 Football, tennis, ice skating, running, jogging, soccer, roller skating
    8 Push-up, boxing, judo, teukgongmoosool, hiking, handball, karate, sit-up, ssireum, kung fu, wrestling, climbing stairs, hapkido
    10 Kickboxing, martial arts, jump rope, taekwondo
    12 Squash

    RateofNCGroupwith Reversionto NC, Groupwith MCI Maintained and Group with Progress to Dementia (N=152)

    Groups n(%)
    Group with reversion to NC 67(44.1)
    Group with MCI maintained 81(53.3)
    Group with progress to dementia 4(2.6)

    NC=normal cognition; MCI=mild cognitive impairment.

    Comparisonsof General CharacteristicsbetweenGroupwith Reversionto NCandGroupwith MCI Maintainedat Base (N=148)

    Characteristics Categories Group with reversion to NC (n=67) Group with MCI maintained (n=81) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Gender Male 18 (26.9) 21 (25.9) 0.02 .522
    Female 49 (73.1) 60 (74.1)
    Age (year)   71.9±5.5 74.9±5.7 -3.31 .001
    65~74 48 (71.6) 38 (46.9) - -
    75~84 19 (28.4) 37 (45.7)
    85 ≥   6 (7.4)
    Education years   8.70±4.71 5.02±4.74 4.71 .001 ＜
    0~5 11 (16.4) 41 (50.6) 18.94 .001 ＜
    6~8 22 (32.8) 17 (21.0)
    9~11 14 (20.9) 9 (11.1)
    12 ≥ 20 (29.9) 14 (17.3)
    Marital status With spouse 40 (59.7) 36 (44.4) 3.42 .071
    Without spouse 27 (40.3) 45 (55.6)

    NC=normal cognition; MCI=mild cognitive impairment.

    Comparison of Cognitive Function, Leisure Activity and Exercise between the Group with Reversion to NC and the Group with MCI Maintained (N=148)

    Characteristics Categories Group with reversion to NC (n=67) Group with MCI maintained (n=81) t p
    M±SD M±SD
    Objective cognitive function (MoCA-K) Baseline 20.60±1.61 17.65±3.41 6.89 .001 ＜
    1 year F/U 25.12±1.68 18.60±3.32 15.43 .001 ＜
    Subjective cognitive function (KDSQ-C5) Baseline 2.78±2.04 3.46±2.55 -1.77 .080
    1 year F/U 2.01±1.94 2.96±2.30 -2.72 .007
    Leisure activity (times/year) Baseline 793.67±372.41 666.91±343.35 2.15 .033
    Watching TV 329.57±103.29 334.73±97.78
    Listening radio 105.57±160.74 75.44±136.46
    Reading newspapers 165.75±165.91 101.24±152.98
    Reading books 138.58±157.71 95.10±143.13
    Playing games 30.31±69.71 38.65±101.37
    Participating cultural class 14.57±33.58 15.24±43.53
    Others 9.33±50.24 6.5±42.13
    1 year F/U 812.04±319.38 678.80±271.21 2.75 .007
    Watching TV 357.99±41.30 362.74±20.33
    Listening radio 97.57±154.95 51.09±125.60
    Reading newspapers 149.52±170.19 100.94±156.65
    Reading books 116.80±156.34 117.49±160.78
    Playing games 30.86±87.44 33.44±95.99
    Participating cultural class 29.10±75.53 6.81±20.72
    Others 30.21±94.80 6.30±20.93
    Exercise (Kcal/week) Baseline 926.20±1,230.57 889.90±1,253.03 0.18 .860
    3 MET 5 ≤ ＜ 1,037.63±725.72 1,058.97±605.02
    5 MET 7 ≤ ＜ 1,257.30±809.61 1,288.14±738.98
    7 MET ≤ 1,598.29±1,009.36 2,601.46±2,148.50
    1 year F/U 925.64±1,186.95 815.00±1,284.12 0.54 .590
    3 MET 5 ≤ ＜ 1,104.29±675.55 1,032.27±594.38
    5 MET 7 ≤ ＜ 916.14±785.60 1,167.92±836.62
    7 MET ≤ 2,000.40±1028.63 3,941.33±2,505.23

    NC=normal cognition; MCI=mild cognitive impairment; MET=metabolic equivalent.
    Table 1. MET (Metabolic Equivalent)

    Table2. RateofNCGroupwith Reversionto NC, Groupwith MCI Maintained and Group with Progress to Dementia (N=152)

    NC=normal cognition; MCI=mild cognitive impairment.

    Table3. Comparisonsof General CharacteristicsbetweenGroupwith Reversionto NCandGroupwith MCI Maintainedat Base (N=148)

    NC=normal cognition; MCI=mild cognitive impairment.

    Table 4. Comparison of Cognitive Function, Leisure Activity and Exercise between the Group with Reversion to NC and the Group with MCI Maintained (N=148)

    NC=normal cognition; MCI=mild cognitive impairment; MET=metabolic equivalent.

    Table 1.

    Table2.

    Table3.

    Table 4.

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