• 제목/요약/키워드: Behavioral and psychological symptoms of dementia

검색결과 38건 처리시간 0.024초

Pharmacotherapy for dementia (치매의 약물요법)

  • Youn, HyunChul;Jeong, Hyun-Ghang
    • Journal of the Korean Medical Association
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    • 제61권12호
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    • pp.758-764
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    • 2018
  • Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

Association between Characteristics of Brain Magnetic Resonance Imaging and Atypical Antipsychotics Use in Dementia Patients (치매 환자에서 뇌 자기공명영상의 특징과 비정형 항정신병 약제 사용여부의 상관 관계)

  • Choi, Jongtaek;Kim, Jiwon;Roh, Yangho;Rhu, Sukhwan;Woo, Sungil;Hahn, Sangwoo;Hwang, Jaeuk
    • Korean Journal of Biological Psychiatry
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    • 제20권3호
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    • pp.97-103
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    • 2013
  • Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.

Factors Affecting On Caregiving Self-efficacy among Dementia Caregivers (치매노인 주부양자의 자기효능감에 영향을 미치는 요인)

  • Choi, Eun-Sook;Kim, Kyung-Sook
    • Research in Community and Public Health Nursing
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    • 제21권2호
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    • pp.210-219
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    • 2010
  • Purpose: The study evaluated the determinants of caregiving self-efficacy among dementia caregivers. Methods: Data were collected through a structured questionnaire survey from dementia sufferers and caregivers by nurses or social workers caring for dementia sufferers at health centers during July to September 2007. Multiple stepwise regression analysis using SAS Version 9.1 was performed to examine the determinants of caregiving selfefficacy. Results: Factors affecting caregiving self-efficacy were behavioral and psychological symptoms of dementia (BPSD), activities of daily living (ADL), and age of dementia sufferer. Conclusion: To increase dementia caregivers' self-efficacy, there is a need to reduce difficulties of dementia caregivers in caring BPSD and increasing the ADL level of dementia sufferers by providing guidelines of care and intervention programs for BPSD and ADL management.

The Effects of Dementia Attitude, Burden of Behavioral and Psychological Symptom in Dementia(BPSD), and Nursing Professionalism on Dementia Nursing Performance among Long-term Care Hospitals Nurses (요양병원 간호사의 치매태도, 치매행동심리증상 부담감, 간호전문직관이 치매간호수행에 미치는 영향)

  • Kang, Da-Hai-Som
    • The Journal of the Convergence on Culture Technology
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    • 제6권4호
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    • pp.301-309
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    • 2020
  • The purpose of this study was identify factors influencing dementia nursing performance among long-term hospitals nurses. Participants were 161 long-term hospitals nurses. Data were collected with structured qustionnaires from November 4 from December 13, 2019. Data were analyzed SPSS/WIN 21 program for descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression. The significant factors of the dementia nursing performance among long-term hospitals nurses were dementia attitude (β=.280, p=.001), nursing professionalism(β=.237, p=.006), burden form BPSD(β=-.174, p=.012), and dementia education experience(β=.166, p=.014). Therefore, in order to improve dementia nursing performance among long-term care hospital nurses, it is necessary to develop program and apply dementia education to establish a positive dementia attitude and nursing professionalism, and to reduce the burden of dementia behavioral and psychological symptoms.

The Change of Plasma Neurotransmitters Concentration after Aromatherapy in Dementia Patients (라벤더향 흡입 후 치매환자의 혈장 중 신경전달물질의 농도변화)

  • Lee, Kyung-Bok;Kang, Young-Sook
    • YAKHAK HOEJI
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    • 제56권2호
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    • pp.86-91
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    • 2012
  • The objective of this study is to examine how different concentration of neurotransmitters in plasma between patients with dementia and normal people regarding the inhalation of lavender oil. This study subjects were 9 elderly patients with dementia who live in nursing home and 9 normal women. Before and after inhalation, they were collected blood sample. Norepinephrine (NE), serotonin (5-HT), dopamine (DA), and r-aminobutyric acid (GABA) concentration analysis were performed. Before inhalation, dementia patients were significantly different with the normal group in GABA and DA, NE. Following inhalation in experimental group, dementia patients and normal group were only significantly increased in 5-HT. But it did not significantly change in the other neurotransmitters. After inhalation, dementia patients were significantly different with the normal group in GABA and 5-HT. This result suggests that the increase of 5-HT release by the inhalation of lavender oil related to reduce the behavioral and psychological symptoms of dementia.

Preliminary Research for Development of Instrument for Cold-Heat & Deficiency-Excess Pattern Identification of Dementia (치매(痴呆)의 한열허실(寒熱虛實) 변증(辨證)을 위한 지표 문항 개발에 관한 기초 연구)

  • Heo, Eun Jung;Kang, Hyung Won;Jeon, Won Kyung
    • Journal of Physiology & Pathology in Korean Medicine
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    • 제27권5호
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    • pp.553-562
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    • 2013
  • This study was performed to develop cold-heat and deficiency-excess pattern identification for dementia, as well as for standard Korean medicine diagnosis and treatment. Five experts comprised of 4 neuropsychiatrists of Korean medicine and 1 statistician to develop cold-heat and deficiency-excess pattern identification for dementia. We searched studies about pattern identification and selected 507 articles using Oasis search terms provided by the KIOM. As a result, 10 pattern identification research study were recruited. Moreover, we analyzed neuropsychological assessments for dementia that evaluate Behavioral and Psychological Symptoms of Dementia (BPSD) and cognitive function using experts conferences and we selected neuropsychological instruments using pattern identification. Six cold patterns, six heat patterns, ten deficiency patterns, and four excess patterns were identified according to the cold-heat and deficiency-excess pattern identification of dementia. We selected the Caregiver-Administered Neuropsychiatric Inventory and the Korean Mini-Mental State Examination as neuropsychological assessments of dementia, which examine behavioral symptoms and cognitive function, suspectively. We formed positive and negative correlation between Korean medicine pattern identification and neuropsychological assessments for dementia. We developed and suggested a forecast module of pattern identification for dementia. But, it is necessary to perform additional clinical trials to verify its validity and accuracy.

Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder (신경인지장애의 정신행동증상에 대한 비약물학적 개입)

  • Hyun Kim;Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • 제31권1호
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    • pp.1-9
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    • 2023
  • Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

Gender Differences in Behavioral Psychological Symptoms of Dementia in Patients with Alzheimer's Disease (알츠하이머병 환자에서 행동심리증상의 성별차이)

  • Lee, Ji Young;Im, Woo-Young;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • 제22권2호
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    • pp.71-78
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    • 2014
  • Objectives : Behavioral and psychological symptoms of dementia(BPSD) represent significant clinical problems, resulting in functional decline, caregiver distress, institutionalization and increased mortality. A recent study showed gender differences have important role in the development of BPSD, but relationship between BPSD and gender has never been studied in Korea. This study was designed to examine whether patients with Alzheimer's disease show gender differences in behavioral and psychological symptoms of dementia(BPSD). Methods : Ninety-eight subjects with Alzheimer's disease were included in this study. We carried out history taking and cognitive assessment for the diagnosis of Alzheimer's disease based on DSM-IV. Cognitive impairment and BPSD were measured using the Mini Mental State Examination(MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating(CDR) and the Korean Neuropsychiatric Inventory(K-NPI). Independent samples t-test was used to examine the differences across gender in BPSD. Correlation analysis between MMSE, CDR, GDS and NPI was performed using Pearson's correlation coefficient. Results : There were no significant gender differences between the gender in BPSD. We found statistically significant negative correlations between MMSE with NPI total score, and with scores of several sub-domains such as hallucination. Conclusions : This study showed that gender differences in BPSD are not significant. Further research is necessary to identify whether BPSD affect gender differences or individual differences.

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Types of Empathy among Nurses Caring for Patients with Behavioral and Psychological Symptoms of Dementia (행동심리증상을 보이는 치매환자를 돌보는 간호사의 공감 유형)

  • Kim, Geun Myun;Lee, Ok-Kyun;Lee, Jeoung-Ran;Kang, Ok-Hee;Jeong, Young-hwa;Chang, Soo Jung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • 제27권3호
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    • pp.306-320
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    • 2020
  • Purpose: This study aimed to explore the subjective perception structures and types of empathy among nurses caring for patients with behavioral and psychological symptoms of dementia (BPSD) using Q-methodology. Methods: Thirty-eight Q-samples (statements) were derived from in-depth interviews with 10 nurses working in long-term care hospitals and nursing homes. The Q-sorting was conducted in rank order (the responses obtained by each of the 30 nurses working at 3 long-term care hospitals and 4 nursing homes) into a normal distribution grid (from -4 to +4). The types of empathy among participants were analyzed using the PC-QUANL program. Results: Five types of empathy accounting for 48.5% of the total variance were categorized as follows: (1) taking the patients' personality into consideration while helping, (2) interacting closely and emotionally, (3) supporting the patient as a companion, (4) performing the duty in a defensive manner, and (5) resolving patients' problems by focusing on their needs. Conclusion: This study shows that there are various types of empathy in nurses caring for patients with BPSD. Therefore, it is necessary to develop strategies and educative programs to enhance empathy competency and deal with burnout based on the type of empathy.

Different Patterns of Behavioral and Psychological Symptoms of Dementia and Caregiver Burden according to Dementia Type in Nursing Home Residents (요양시설 치매노인의 치매유형에 따른 행동심리증상 특성과 간호제공자의 업무 부담감)

  • Gang, Min-Suk;Choi, Hyun-A;Hyun, Jin-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제17권5호
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    • pp.459-469
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    • 2016
  • The purpose of this study was to examine different patterns of behavioral and psychological symptoms of dementia (BPSD) and caregiver burden according to dementia type. Data were collected from June 2014 to December 2014 from five nursing homes. In all, 214 patients [131 patients with Alzheimer's disease (AD) and 83 patients with Vascular dementia (VD)] were included in the study. BPSD and caregiver burden data were examined using NPI-NH (Neuropsychiatric Inventory Nursing Home Version). According to the results, both the AD and VD group showed the highest frequency in apathy/indifference and the frequency of anxiety, elation/euphoria, and irritability/lability was significantly higher in the AD group than in the VD group. The difference in total BPSD composite scores between the AD and VD groups was not significant but agitation/aggression was significantly higher in the AD group than in the VD group. The mean score for caregiver burden was significantly higher in the AD group than in the VD group, particularly in agitation/aggression. In conclusion, BPSD differed according to dementia type, and nurses should provide specific interventions to control BPSD; a program to reduce caregiver burden according to dementia type is also needed.