• Korean Journal of Psychosomatic Medicine
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• v.22 no.1
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• pp.40-45
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• 2014

Objectives : Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. Methods : A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). Results : The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. Conclusions : These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.

• Journal of Oriental Neuropsychiatry
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• v.17 no.1
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• pp.145-152
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• 2006

The purpose of this study was to investigate the clinical application of oriental medical therapy to Pick's disease We treated the patient with oriental medical therapy. The recovery of the dementia was evaluated by Korean-Mini Mental State Examination(MMSE-K), Korean-dementia Rating Scale(K-DRS) & Barthel ADL Index.(ADL) The applicability of oriental medical therapy has positive effects on the patient with Pick's disease. The Sum of MMSE-K score was increased. K-DRS & ADL were also promoted.

• Journal of Biomedical Engineering Research
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• v.40 no.5
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• pp.189-196
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• 2019

We investigated differences in ventricular and hippocampal volumes between CSF tap test (CSFTT) responders and non-responders in idiopathic normal-pressure hydrocephalus (INPH) patients and compared these parameters in INPH patients with that of age- and gender-matched healthy controls. We also evaluated relationships between ventricular and hippocampal volumes and clinical profiles in INPH patients. We enrolled 48 patients with INPH and 29 healthy controls. Ventricular and hippocampal volumes were measured on MRI, including 3-dimensional volumetric images. INPH patients, when compared to healthy controls, had significantly larger ventricular and smaller hippocampal volumes. No difference in ventricular and hippocampal volumes was found between CSFTT responders and non-responders in INPH patients. And hippocampal volumes showed significant negative correlations with Clinical Dementia Rating Scale scores, INPH grading scale cognitive scores, Timed Up and Go Test scores, and Unified Parkinson's Disease Rating Scale motor scores in INPH patients. Volumetric assessment of ventricular and hippocampal regions may have no predictive value in differentiating between CSFTT responders and non-responders in INPH patients. Our findings may help us understand the potential pathophysiology of unique symptoms associated with INPH.

• Research in Community and Public Health Nursing
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• v.19 no.1
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• pp.36-45
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• 2008

Purpose: This study was to estimate the prevalence of dementia in order to estimate the associations of dementia with its risk factors in the community elderly. Methods: The multistage random cluster sampling method was used to select the subjects. The response rate was 94.3%. For the 1st stage screening survey, the Korean-version Mini-Mental State Examination (K-MMSE) and the Bathel Index of activities of daily living (ADL) and instrumental activities of daily living (IADL) were used as primary screening tools. At the 2nd stage. diagnoses were confirmed according to the Clinical Dementia Rating Scale (CBR) and Computer Tomogram (CT). Results: Age-sex adjusted prevalence (%) [95% CI] of dementia was 6.25% [4.47-7.83] (male 4.21% [2.40-6.02]; female 8.28% [5.71-10.85]). Four statistically significant risk factors of the dementia were identified: age 70-74 (OR=1.367), age 75-79 (OR=1.712), age 80-84 (OR=2.465), age 85 over (OR=7.363) illiteracy (OR=3.827); unconsciousness after head injury (OR=3.383), and no exercise (OR=2.188). Hosmer and Lemeshow goodness-of-fit index of dementia risk model was E (legit of dementia)= -4.337+$0.312^*Age(70{\sim}74)+0.538^*Age(75{\sim}79)+0.902^*Age(80{\sim}84)+1.996^*Age$(85over)+$1.342^*$Illiteracy+$1.219^*$Unconsciousness after head trauma+$0.783^*$No exercise. We confirmed that the overall prevalence of dementia in adults aged 65 and older was 94.3%. The risk factors of dementia were explained by age, illiteracy unconsciousness after head trauma and no exercise. Conclusion: These data have been used to estimate the incidence of dementia in elderly community population and to manage the possible role of risk factors as predictors of dementia.

• Dementia and Neurocognitive Disorders
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• v.17 no.3
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• pp.100-109
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• 2018

Background and Purpose: Although the clock drawing test (CDT) is a widely used cognitive screening instrument, there have been inconsistent findings regarding its utility with various scoring systems in patients with mild cognitive impairment (MCI) or dementia. The present study aimed to identify whether patients with MCI or dementia exhibited impairment on the CDT using three different scoring systems, and to determine which scoring system is more useful for detecting MCI and mild dementia. Methods: Patients with amnestic mild cognitive impairment (aMCI), vascular mild cognitive impairment (VaMCI), mild Alzheimer's disease (AD), mild vascular dementia (VaD), and cognitively normal older adults (CN) were included. All participants were administered the CDT, the Korean-Mini Mental State Examination (K-MMSE), and the Clinical Dementia Rating scale. The CDT was scored using the 3-, 5-, and 15-point scoring systems. Results: On all three scoring systems, all patient groups demonstrated significantly lower scores than the CN. However, while there were no significant differences among patients with aMCI, VaMCI, and AD, those with VaD exhibited the lowest scores. Area under the Receiver Operating Characteristic curves revealed that the three CDT scoring systems were comparable with the K-MMSE in differentiating aMCI, VaMCI, and VaD from CN. In differentiating AD from CN, however, the CDT using the 15-point scoring system demonstrated the most comparable discriminability with K-MMSE. Conclusions: The results demonstrated that the CDT is a useful cognitive screening tool that is comparable with the Mini-Mental State Examination, and that simple CDT scoring systems are sufficient for differentiating patients with MCI and mild dementia from CN.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.1082-1093
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• 2021

Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication. Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment. Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.

• YAKHAK HOEJI
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• v.37 no.5
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• pp.442-452
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• 1993

Previous experimental and clinical investigations suggest a possible role of new nootropic drug, oxiracetam, in improving cognitive performances in patients affected by organic brain syndrome. In this study, the cognitive and behavioral effects of oxiracetam treatment in patients with clinical symptoms of organic brain syndrome were evaluated. Sixty-six patients were enrolled and assigned to either oxiracetam or placebo, according to a randomized, double-blind design between two patient-groups. Either oxiracetam or placebo was orally given bid for 8 weeks ; daily dose of oxiracetam was 1600mg. All the patients, enrolled in this study, were diagnosed as having mild to moderate cognitive dysfunction as defined by a baseline Mini Mental State ExaminationKorean version (MMSE-K) score between 14 and 25. The patients under-went, at baseline, 4 weeks and 8 weeks after, routine laboratory study (CBC, SMA12, U/A, EKG) and the following neuropsychological tests ; MMSE-K, modified Korean Wechsler Intelligence Scale(MKWIS), Nurses' Observation Scale for Geriatric patients(NOSGER). Fifteen patients of whom were dropped out or excluded from the analysis because of poor compliance or violation of the protocol. Fiftyone patients (aged 54~78 years, male 25, female 26) were analyzed (vascular dementia, 30 ; senile dementia of Alzheimer type, 9 ; mixed type, 5 ; other cause, 7). Statistical analysis of the data demonstrated that the two groups were comparable at baseline. At the end of each study period the oxiracetam group scored significantly better on the majority of the tests evaluating cognitive function, psychometricity and the improvement rating scale of subjective symptoms than placebo group, in which worsening trends or no changes were seen on the whole. No side effects were noted during oxiracetam treatment. The present study, showing positive clinical findings after oxiracetam therapy, confirmed that this drug can be useful pharmacological treatment in organic brain syndrome.

• Journal of Pharmacopuncture
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• v.22 no.4
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• pp.279-283
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• 2019

Hominis placenta pharmacopuncture, a treatment that injects Hominis placenta extract into acupoints, has been suggested in the literature and researches that it could be used for cognitive decline. We experienced a case of mild neurocognitive disorder treated with Hominis placenta pharmacopuncture. Hominis placenta pharmacopuncture could be a possible treatment modality producing substantial clinical result in cognitive function which is assessed with Mini-Mental State Examination-Dementia Screening (MMSE-DS), Korean Version of Montreal Cognitive Assessment (MoCA-K), and Korean-Dementia Rating Scale (K-DRS). A 84-year-old man with mild neurocognitive disorder received Hominis placenta pharmacopuncture on GV20, CV12, and bilateral ST36 for a month. The results of neuropsychological examination showed increase in scores after treatment of Hominis placenta pharmacopuncture. Before treatment, they were 15 points for MoCA-K, and 120 points for K-DRS (7.6%), but after treatment, they elevated by 21 points for MoCA-K and 137 points for K-DRS (100%). MMSE-DS score was 28 points, unchanged before and after treatment. It did not cause any side-effect. Hominis placenta pharmacopuncture could be a safe option for treating mild neurocognitive disorder.

• Journal of Oriental Neuropsychiatry
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• v.14 no.1
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• pp.17-26
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• 2003

Objective : The clinical efficacy of Jowiseungchungtang(oriental herbal medication) over 6-month on the cognitive function in patients with mild Dementia of Alzheimer type(DAT) was investigated in this study. Method : The subjects for this study consisted of dementia patients who visited to the outpatient dementia department of Oriental Neuropsychiatry of the Kyunghee Oriental hospital. Patients were required to have at entry: a dignosis of mild DAT; Biochemical test, CBC, Urine analysis, Chest X -ray, EKG, Brain- MRI, Mini-Mental States-Korea(MMSE-K), Korean-Dementia Rating Scale(K-DRS), Samsung Dementia Questionaire(SDQ;to their caregiver). Patients(n=31) were assigned to treatment with Jowiseungchungtang (fourth/day for 6-month). The primary outcome measure was K-DRS. Result : 1. Patients' mean age was $71.4{\pm}6.6$ years(range 59 to 86 years). 2. Patients' mean education was $6.1{\pm}4.9$ years. K-DRS scores at baseline was $110.5{\pm}12.2$. K-DRS scores at 6-month was $109.0{\pm}17.0$. K-DRS scores at 6-month was not significantly different with K-DRS scores at baseline(t=.791 r=.435 p<.05). Conclusion : Treatment with Jowiseungchungtang for 6-month protected the cognitive function decline in patients with mild DAT.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.155-163
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• 2019

Objectives : The aim of this study was to compare severity, neurocognitive functions, and behavioral and psychological symptoms of dementia (BPSD) according to the degree of temporal lobe atrophy (MTA) in Korean patients with dementia due to Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease. Methods : Participants were 114 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. Severity was evaluated with Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Neurocognitive functions was evaluated with the Korean version of Short Blessed Test (SBT-K) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). BPSD was evaluated with the Korean version of the Neuropsychiatric Inventory (K-NPI). Independent t-test was performed to compare severity, neurocognitive functions, and BPSD between two groups. Results : The group with high severity of MTA showed significantly lower scores in CDR, SBT-K, MMSE-KC, modified Boston naming test, word list recognition, and word list memory (p<0.05). There were no differences in K-NPI scores between two groups. Conclusions : Severity and neurocognitive functions of dementia had significant positive association with MTA, but BPSD had no association with MTA. Evaluating MTA seems to have potential benefit in diagnosing and treating neurocognitive impairments in the elderly. Further evaluation is needed to confirm the association between certain brain structures and BPSD.