• Journal of Music and Human Behavior
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• v.19 no.2
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• pp.1-26
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• 2022

This review was conducted to identify the research trends in music intervention studies with elderly patients with dementia. Korean- and English-written studies on music intervention for this population were searched and analyzed. Seventeen studies were included in the final analysis. The results showed that behavioral and psychological symptoms were the main dependent variables. In terms of the type of music intervention employed, interventions requiring the patient's active participation in producing music were more common than interventions that required the patient to only listen to music. The majority of studies provided live music, selected music that was familiar to and preferred by the patient, and utilized rhythm-based performance activities. In the studies using active music production as the intervention, the participants were asked to express the emotions evoked by group instrument playing or singing along with music, which doesn't reflect the functional limitations (e.g., cognitive impairment) of elderly patients with moderate to severe dementia. The results of this review point to the need in the field to develop music intervention programs for the elderly with moderate to severe dementia that meaningfully engage these patients in music-related behaviors that target their specific symptomology.

• Journal of Oriental Neuropsychiatry
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• v.32 no.2
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• pp.111-127
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• 2021

Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic-pituitary-adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.260-269
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• 2018

This study investigated the needs of the elderly with dementia from the perspectives of patients and caregivers in long-term care facilities. A total of 145 older adults with dementia and 62 nurses from 3 geriatric hospitals were enrolled in this study. The cognitive function, behavioral and psychological symptoms, activities of daily living (ADL), and instrumental activities of daily living (IADL) were measured. The mean number of needs reported by the elderly with dementia was 11.94 and those with unmet needs were 2.91 on average. Nurses showed that the mean number of needs and unmet needs of the elderly with dementia was 14.71 and 1.94, respectively. The largest number of older adults with dementia (42.2%) perceived that the needs for daytime activities were unmet. On the other hand, only 24.1% of nurses evaluated that the needs for daytime activities were unmet. The factors influencing the needs of the elderly with dementia were dependency in ADL and IADL. Therefore, caregivers in long-term care facilities need to take the perception of older adults with dementia into consideration when evaluating the met and unmet needs of the elderly with dementia. In addition, sufficient assistance to IADL and ADL would help reduce the needs of people with dementia.

• Journal of Oriental Neuropsychiatry
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• v.32 no.2
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• pp.81-93
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• 2021

Objectives: Mild cognitive impairment (MCI) is condition of cognitive decline shown in transition from normal aging to dementia. Hominis placenta pharmacopuncture (HPP) is a treatment that combines effects of medication and acupuncture by injecting Hominis placenta into acupoints. The objective of this study was to evaluate the efficacy and safety of HPP for MCI. Methods: This was a randomized, double-blind, placebo-controlled, two-center clinical trial. Eligible patients were randomly allocated to either the HPP group or the placebo group. HPP or saline as placebo was administered to participants for eight weeks. Changes in symptoms were observed. The primary outcome was difference in mean change of Korean Version of the Montreal Cognitive Assessment (MoCA-K) score between the HPP group and the placebo group. Cognitive function, overall status of mood and sleep, and quality of life (QoL) were also assessed. Safety assessment and economic analysis were then conducted. Results: Thirty participants were enrolled. One participant in the placebo group dropped out. The score of MoCA-K increased after treatment. Its mean change was smaller in the HPP group than in the control group. HPP ameliorated Global Deterioration Scale and Korean Dementia Rating Scale subtests for attention, organization, and memory compared to the placebo. However, none of them was significantly different between the two groups. Mood, sleep, and QoL all improved more in the HPP group than in the placebo group, although differences between the two groups were not statistically significant. There was no adverse event probably related to the drug. HPP treatment needed KRW 345,000 more than the placebo group in improving Geriatric Quality of Life scale-Dementia score by one point for one year. Conclusions: Although HPP treatment did not significantly improve cognition, it changed behavioral and psychological symptoms in MCI.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.42-57
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• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• 한국노년학
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• v.29 no.4
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• pp.1591-1609
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• 2009

Adult child caregivers and spousal caregivers might deal with differential challenges. Studies about caregivers' psychological outcomes, however, tended to investigate associations between caregiving and its outcomes by pooling adult child caregivers and spousal caregivers together. By using a U. S. sample of family caregivers who assisted a relative with dementia, this study examined whether the relationship of caregivers to care receivers (daughter caregivers or spousal caregivers) made a difference in levels of depressive symptoms. The result showed that wife caregivers were more likely to be depressed than daughter caregivers. For daughter caregivers, role overload, role captivity, and behavior problems significantly influenced on depression. Besides these variables, the level of education was a significant predictor for wife caregivers. Role captivity and behavior problems significantly impacted on depression for husband caregivers. Thus, role captivity and behavioral problems were common predictors for all the caregivers. Specifically, higher levels of role captivity and behavioral problems were likely to make caregivers more depressed. The implication of these results were discussed.

• Journal of Oriental Neuropsychiatry
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• v.31 no.4
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• pp.301-314
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• 2020

Objectives: The purpose of this study was to provide clinical evidence to support the use of herbal medicine combined with western medicine for BPSD. Methods: Studies were identified by searching CNKI, Pubmed, EMBASE, Cochrane Library, SCIENCEON, RISS, KMbase, KISS, OASIS. Literature searches of Chinese, English, and Korean databases were performed. Two authors independently extracted the data and evaluated the quality of each study. Results: The literature search identified 203 articles. Of these, 7 were selected for the analysis. The risk of bias in most studies was unclear. The most frequently used diagnostic tools were the NINCDS-ADRDA and DSM-IV. The most commonly used results indicator was NPI. In 6 of the 7 papers, combination treatment (herbal & Western medicine) was statistically significantly more effective than single treatment (Western medicine alone) for BPSD. No significant adverse events were reported. Conclusions: Herbal medicine in combination with Western medicine is more effective for treating BPSD than Western medicine alone. However, the quality of the studies used in this study was uncertain and the sample size was too small. Based on the findings of this study, more high-quality clinical trials are needed to confirm the efficacy of combination treatment.

• The Journal of Korean society of community based occupational therapy
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• v.2 no.1
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• pp.37-47
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• 2012

Objective : The purpose of this study was to identify Effects of the ROM dance on cognitive function, neuropsychiatric in using wheelchair senior in nursing home. Methods : The subjects of the experimental group were 15 seniors using wheelchair who attended an ROM dance program in a nursing home. It was carried out for 18 weeks from Mar. 2010. to August. 2010. The evaluation tools used for the presented study were the Mini-Mental Status Exam-Korean(MMSE-K) and Neuropsychiatric Inventory-Questionaire (NPI-Q). Results : In the terms of cognitive function there was no significant defference between the mean pre/post test. but the factor(orientation of time) of MMSE-K and the factors 2 (sleep/nighttime behavios, apathy/indefference) of NPI-Q was significant improvement. Conclusion : In this study, the ROM dance program was effective in improving cognitive function and neuropsychiatric in seniors using wheelchair. also ROM dance program was decreasing and regression delay effect in cognitive and neuropsychiatric.