The goal of this observational study is to learn how daily emotional stress affects cognitive function and inflammation in community-dwelling older adults aged 60 and older in Seoul, Republic of Korea. The main questions it aims to answer are:
Does daily psychological stress measured in real-time affect short-term and long-term cognitive function in older adults? Do pro-inflammatory cytokines (such as CRP, IL-6, IL-10, and TNF-α) mediate the relationship between emotional stress and cognitive decline? How do social support and social isolation influence cognitive function and inflammatory biomarkers over time?
Participants will:
Complete baseline surveys assessing depression, cognitive function, and personal characteristics Use a smartphone app to answer brief surveys about their emotions, cognitive performance, and social interactions 1-6 times daily for two weeks Wear a Galaxy Watch to track sleep quality, heart rate, and physical activity Provide blood samples for inflammatory biomarker analysis Return for follow-up assessments at 6 months and 1 year
This study is part of an international collaboration to establish a Korean cohort comparable to the U.S. Einstein Aging Study, with the aim of developing culturally tailored dementia prevention strategies.
Adults aged 60 or older residing in the Republic of Korea
Samsung Galaxy smartphone users capable of using smartphone applications
Sufficient cognitive ability to understand and follow research instructions (MMSE score of 21 or above)
For individuals who do not meet the cognitive criteria, those who understand the study procedures and provide informed consent along with their legal guardian
Diagnosis of dementia at baseline
Severe visual or hearing impairments that prevent participation in psychological assessments
Illiteracy that prevents participation in cognitive testing
Less than 80% compliance with the 2-day preliminary EMA protocol (one additional attempt allowed after re-training)
This study targets community-dwelling older adults aged 60 and older in Seoul, Republic of Korea. Participants are recruited from the Seongbuk Senior Welfare Center and Gangbuk Municipal Senior Welfare Center. Seongbuk-gu and Gangbuk-gu are districts with higher proportions of older adults and elevated chronic disease rates compared to other areas in Seoul, making them regions of interest for aging research. The study population includes older adults living independently in the community who utilize local senior welfare center services. By recruiting from these districts, the study aims to generate evidence for developing effective dementia prevention strategies applicable to community-based settings in Korea. Participants must be Samsung Galaxy smartphone users with sufficient cognitive ability to engage with ecological momentary assessment (EMA) protocols. Exclusions: dementia diagnosis, severe sensory impairments, or health conditions preventing participation.
Cohort
Prospective
Not listed
Incident MCI and Dementia Diagnosis
Incident mild cognitive impairment (MCI) and dementia diagnoses will be identified through clinical diagnosis during the study periods and linkage with the National Health Insurance Service (NHIS) database in Korea. This administrative data linkage enables long-term tracking of cognitive outcomes beyond the active study period.
SNSB-2 Composite Score
Composite score from the Seoul Neuropsychological Screening Battery-2 (SNSB-2), a standardized neuropsychological assessment covering attention, language, visuospatial function, memory, and executive function domains (Standardized composite z-score).
Wechsler Memory Scale Score
Memory function assessed using the Wechsler Memory Scale (Index score (points)).
Block Design Subtest Score
Visuospatial constructional ability assessed using the Block Design subtest from the Wechsler Adult Intelligence Scale (WAIS) in Scaled score (points).
EMA Daily Negative Affect
Daily negative emotional states measured via smartphone-based EMA surveys administered 1-6 times per day during the 2-week intensive period (0-100 scale).
EMA Daily Positive Affect
Daily positive emotional states measured via smartphone-based EMA surveys administered 1-6 times per day during the 2-week intensive period. The scores are assessed by a mean score (0-100 scale).
Depressive Symptoms
Depressive symptoms assessed using the Patient Health Questionnaire-9 (PHQ-9) at each follow-up visit. Yes/No coding will be used to assess reports of depressive symptoms.
EMA Daily Social Interaction Frequency
Frequency of daily social interactions measured via smartphone-based EMA surveys during the 2-week intensive period. Unit of Measure: Number of interactions per day
Serum Cortisol Level
Cortisol level measured from serum samples using enzyme-linked immunosorbent assay (ELISA) (nmol/L).
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Korea University
Lead sponsor
Korea University Anam Hospital
Collaborator
Penn State University
Collaborator
Albert Einstein College of Medicine
Collaborator
