Policy Implications of the Effectiveness of Leisure Activity Programs for Older Adults with Disabilities through Evidence-Based Policy (EBP) Utilizing Field-Centered Living Lab

다국어 초록 (Multilingual Abstract)

(Purpose) The purpose of this study was to analyze the results of a cognitive enhancement program for older adults with disabilities using a field-centered Living Lab approach based on evidence-based policy. It aims to propose new directions for institutional foundations and policy infrastructure related to Living Labs and provide final recommendations for development through practical case analysis.
(Design/Methodology) This study was designed to propose new institutional improvements and suggestions through the development of evidence-based policies based on field-centered Living Lab cases. To address the field cases of intermediary organizations, representative examples of field-centered Living Labs were selected. The study focused on elderly individuals aged 65 and over with disabilities who lived in S, Gyeonggi Province, and attended senior welfare centers, with a focus on those selected by institutions as having mild cognitive impairment. The case analysis results were derived from these participants. Additionally, a quantitative and qualitative evaluation tailored to the characteristics of elderly individuals with disabilities was conducted through expert consultations, followed by a satisfaction survey after a certain period. Finally, recommendations were derived based on expert consultations within the governance framework of the intermediary organization.
(Findings) In the process of utilizing evidence-based policy to transform field-based Living Lab cases into policy, a significant difference was found from the typical policy-making process, particularly in the selection of the field and the overall Living Lab process. The execution plan for the intermediary governance model, considering pre-planning and diffusion models, greatly impacted the results of the study. Therefore, in this study, the case of elderly individuals with disabilities and mild cognitive impairment in a senior welfare center in S, Gyeonggi Province, was analyzed for the dementia prevention effects of new ICT devices, broken down by dementia stages. The pre- and post-program effects were verified, and feedback from the institution, which had implemented the Living Lab within the system for three years, was used to finalize the policy application process.
The study found that elderly individuals utilizing the welfare center showed significant improvements in mental state after participating in the cognitive enhancement program, along with reductions in body fat percentage and blood pressure. Notably, mental state and memory decline showed significant differences based on age and health status, with female seniors exhibiting higher mental states. Furthermore, after the 10-week short-term program, subjective well-being scores, feelings of depression and anxiety, and subjective memory decline (SMOQ) improved, indicating a significant enhancement in mental state. Based on these findings, the study proposed directions for activating future Living Lab research and policy development based on evidence-based policies to improve cognitive function in elderly individuals using the S senior welfare center.
(Research Implications or Originality) The empirical results of field-based Living Labs for solving various social problems, ranging from technological development to public policy, budget formulation, and future advancement, are essential for policy implementation based on intermediary organizations and public suggestions. This study highlights significant implications for developing new methods and future directions for policy-making processes that can rapidly adapt to the changing times, similar to international policy-making processes. Additionally, it emphasizes the need for preventive program development and support through various cognitive enhancement programs, regular dementia prevention education, early screening tests, and continued treatment after an initial dementia diagnosis. The proposed direction includes considering multi-agency int...

참고문헌 (Reference)

• 1 Bae, S. Y., "[How to Utilize Insurance 200%] Dementia Patients Need Care for an Average of 12 Years Post-Diagnosis… Long-Term Care Insurance is Essential"
• 2 Fisher, G. G., "Work across the lifespan" Academic Press 17-45, 2019
• 3 Abbott, R. D., "Walking and dementia in physically capable elderly men" 292 (292): 1447-1453, 2004
• 4 Wu, Y. T., "The association between community environment and cognitive function : a systematic review" 50 (50): 351-362, 2015
• 5 Korea Institute for Health and Social Affairs, "The UK NHS" 2016
• 6 최호진 ; 김승현 ; 이재홍 ; 이애영 ; 박건우 ; 이은아 ; 최성혜 ; 나덕렬 ; 정지향, "The Present and Future of the National Responsibility System for Dementia" 36 (36): 152-158, 2018
• 7 Jung, H.Y., "The Pre-Dementia Stage ‘Mild Cognitive Impairment’ Triples in Five Years"
• 8 강수연 ; 김호영 ; 염유식, "The Impact of Social Activities in Old Age on Cognitive Function: The Moderating Effect of Education" 35 (35): 563-587, 2016
• 9 Kim, S. Y., "The Fear of Dementia" Department of Neurology, Seoul National University Bundang Hospital
• 10 Health Insurance Review & Assessment Service, "Statistics on Medical Expenses for 2017"
• 11 박영란 ; 박경순, "Social Networks and Welfare of Korean Seniors: Trends in Research and Future Tasks" 60 : 323-352, 2013
• 12 김호영, "Social Life in Old Age and Cognitive Function" 34 (34): 225-251, 2015
• 13 류한소 ; 이민아, "Social Interaction and Cognitive Function in the Elderly : Age-Related Differences" 42 (42): 65-89, 2019
• 14 WHO Guidelines Approved by the Guidelines Review Committee, "Risk reduction of cognitive decline and dementia: WHO Guidelines"
• 15 Terekeci, H. M., "Relationship between anaemia andcognitive functions in elderly people" 21 (21): 87-90, 2010
• 16 박민규 ; 김대진, "Problems and improvement of statistics-based policy management system as an evidence-based policy formation system" 21 (21): 1-39, 2021
• 17 Statistics Korea, "Prevalence of Dementia by Region and Nationwide"
• 18 박남희 ; 이윤미 ; 이루리, "Prevalence and Risk Factors of Dementia Among Community-Dwelling Elderly" 19 (19): 36-45, 2008
• 19 이현주, "Participation in Social Activities and Cognitive Function in Middle-Aged and Older Adults: A Longitudinal Study of Interrelationships" 43 (43): 138-167, 2015
• 20 최호진 ; 김승현, "National Responsibility System for Dementia and Patient Management" 61 (61): 309-313, 2018
• 21 Petersen, R. C., "Mild cognitive impairment as a diagnostic entity" 256 (256): 183-194, 2004
• 22 Petersen, R. C., "Mild Cognitive Impairment : Aging to Alzheimer's Disease" Oxford University Press 2003
• 23 송영수 ; 김태백 ; 배남규 ; 조영채, "Mental Health Status of Long-Term Care Insurance Recipients and Related Factors" 19 (19): 247-260, 2018
• 24 Kim, J M., "Issues and Improvement Strategies of Current Health Policies for Dementia Patients" 7 (7): 133-150, 2006
• 25 "Central Dementia Center Dementia Partner Website"
• 26 Central Dementia Center, "Annual Report of the Central Dementia Center" 2017
• 27 박소임, "Analysis of the Effectiveness of Implemented Programs for Improving the Design Directions of Customized Integrated Cognitive Function Programs for Older Adults with Mild Cognitive Impairment" 14 (14): 209-236, 2024
• 28 Ministry of Health and Welfare, "4th Comprehensive Plan for Dementia Management(2021-2025)" 2020
• 29 Statistics Korea, "2022 Population Projection"
• 30 Statistics Korea, "2021 Statistics on the Elderly"
• 31 Statistics Korea, "2020 Statistics on the Elderly"