This study investigated age-related changes of cognitive function in Korean adults using the Korean-Developmental Test of Visual Perception-2 (K-DTVP-2) and the Visual Motor Integration-3rd Revision (VMI-3R) test, and determined the main factors influencing VP and VMI in older adults. For this research, 139 adults for the K-DTVP-2 and 192 adults for the VMI-3R, from a total of 283 participants, were randomly and separately recruited in province, Korea. The present study showed that the mean score of the K-DTVP-2 and VMI-3R in 10-yr age increments significantly decreased as age increased (K-DTVP-2, F= 41.120, P< 0.001; VMI-3R, F= 16.583, P< 0.001). The mean score of the VMI-3R and K-DTVP-2 were significantly decreased in participants in their 50s compared to those in their 20s (P< 0.05). Age (t= −9.130, P< 0.001), gender (t= 3.029, P= 0.003), and the presence of diseases (t= −2.504, P= 0.013) were the significant factors affecting K-DTVP-2 score. On the other hand, age (t= −6.300, P< 0.001) was the only significant factor affecting VMI-3R score. K-DTVP-2 score (Standardized β= −0.611) decreased more sensitively with aging than VMI-3R (Standardized β= −0.467). The two measurements had a significant positive correlation (r = 0.855, P< 0.001). In conclusion, it can be suggested that VP and VMI should be regularly checked from an individual’s 50s, which is a critical period for detecting cognitive decline by aging. Both the K-DTVP-2 and VMI-3R could be used for determining the level of cognitive deficit by aging.

This study investigated the influence of diabetes on cognitive decline between the diabetes and non- diabetes patients and identified the associations between diabetes and cognitive function, visual perception (VP), and visual motor integration (VMI). Sixty elderly men (67.10± 1.65 yr) with and without diabetes (n= 30 in each group) who were surveyed by interview and questionnaire in South Korea were enrolled in this study. The score of Mini-Mental State Examination of Korean version (MMSE-KC), Motor-free Visual Perception Test-Vertical Format (MVPT-V), and Visual-Motor Integration 3rd Revision (VMI-3R) were assessed in all of the participants to evaluate cognitive function, VP, and VMI in each. The score of MMSE-KC in the diabetic group was significantly lower than that of the non-diabetes group (P< 0.01). Participants in the diabetes group also had lower MVPT-V and VMI-3R scores than those in the non-diabetes group (P< 0.01, respectively). Especially, the scores of figure-ground and visual memory among the subcategories of MVPT-V were significantly lower in the diabetes group than in the non-diabetes group (P< 0.01). These findings indicate that the decline in cognitive function in individuals with diabetes may be greater than that in non-diabetics. In addition, the cognitive decline in older adults with diabetes might be associated with the decrease of VP and VMI. In conclusion, we propose that VP and VMI will be helpful to monitor the change of cognitive function in older adults with diabetes as part of the routine management of diabetes-induced cognitive declines.

Effective methods to detect old people cognitive decline in early stages are needed in Korea, which is the fastest aging country in the world. This study aimed to develop a brief cognitive function measurement, Visual-Motor Integration Scale for the Korean elderly (VMIS-KE). In this methodological research, 16 preliminary items on visual-motor integration for the old people were chosen after literature review and expert validation. One hundred eighty participants aged 20-79 years were recruited to verify the validity and reliability of this measurement from community sources in Daegu city. The collected data were analyzed by exploratory factor analysis and confirmative factor analysis using SPSS and AMOS 18.0 program. The three factors (figure cognition, memory, and spatial cognition) with 12 items were finally extracted. Goodness of the fit was confirmed through confirmatory factor analysis. The Cronbach α was 0.867. The scores of overall VMIS-KE and every subcategory significantly decreased with age, especially in the 70s. VMIS-KE is the first valid and reliable measurement to assess cognitive decline of the Korean old people through visual motor integration, and can easily and quickly detect high-risk groups of dementia regardless of their educational level.

This study aimed to investigate the adequacy of the visual-motor integration (VMI) scale for Korean elderly (VMIS-KE) compared to traditional measures, mini-mental state examination of Korean version (MMSE-KC) and Beery VMI for cognitive decline in diabetic older adults. For this explanatory research, data were collected from September 1 to September 15, 2013, from 34 diabetic older adults and 31 nondiabetic older adults in Daegu and Gyeongsan of Korea. Mean differences between the two groups were analyzed with SPSS 18.0. The diabetic older adults showed significantly lower scores in the VMIS-KE (<i>t</i>= 4.128, <i>P</i>< 0.001) and MMSE-KC (<i>t</i>= 2.231, <i>P</i>= 0.029) compared with the nondiabetic older adults. In all subcategories of VMI-KE, figure cognition (<i>t</i>= 5.342, <i>P</i>< 0.001), memory (<i>t</i>= 3.011, <i>P</i>= 0.004) and spatial cognition (<i>t</i>= 2.639, <i>P</i>= 0.011), there were significant differences whereas no significant difference in the VMI-6th revision (<i>t</i>= 0.994, <i>P</i>= 0.325). VMIS-KE could be a sensitive indicator to assess cognitive change in older adults with diabetes and health care providers should periodically evaluate vulnerable groups such as them with it.