• 제목/요약/키워드: Clinical Dementia Rating Scale

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COVID-19 감염 후 알츠하이머 치매증상의 악화에 대한 억간산 가미 치험 1례 (A Case Report of Worsening Alzheimer's Disease Symptoms after COVID-19 Infection That Were Treated with Yigan-san-gami)

  • 이효정;권선우;권이재;손정민;박충현;이지윤;이정은
    • 대한한방내과학회지
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    • 제45권2호
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    • pp.149-158
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    • 2024
  • Introduction: In this case report, we describe the clinical effectiveness of Yigan-san-gami in improving symptoms in a patient with worsening Alzheimer's dementia after COVID-19 infection. Case presentation: Symptoms of dementia worsened in a patient with Alzheimer's disease after COVID-19 infection. Western medicines were added following neurological consultation. However, there was no medicinal effect. The patient was treated with Korean medicine (Yigan-san-gami) three times a day. We used daily charts, the Korean Mini-Mental State Examination-2 (K-MMSE-2), Clinical Dementia Rating (CDR), and Short Version Geriatric Depression Scale (SGDS) to assess the patient's symptoms. Cognitive decline and behavioral and psychological symptoms of dementia (BPSD) improved following the treatment with Yigan-san-gami. Conclusion: The results suggest that Yigan-san-gami may be effective in improving symptoms of Alzheimer's disease that worsen after COVID-19 infection.

치매 환자의 매선 요법 치료에 관한 치험 3예 (The Case Report of 3 Dementia Patients Treated by Needle-Embedding Therapy)

  • 배달빛;박장호;유윤선;이고은;정현국;강형원;유영수
    • 동의신경정신과학회지
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    • 제23권3호
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    • pp.99-116
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    • 2012
  • Objectives : The purpose of this study is to evaluate the effects of Needle-Embedding Therapy on dementia patients. Methods : We recruited 3 dementia patients who have been experiencing memory disorder and orientation disorder. The patients had been evaluated with Mini-Mental State Examination-K (MMSE-K), Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR). The patients were treated with herbal medication (Sunghyangjunggi-san) and acupuncture. After 15 days, the patients were added to Needle-Embedding Therapy. We measured MMSE-K, GDS and CDR for every 15 days. The effects of additional Needle-Embedding Therapy were compared with the effects of acupuncture and herbal medicine. Results : After Needle-Embedding Therapy was added, Patients' memory and orientation have been improved and the score of MMSE-K ascended. The grade of GDS and CDR were maintained or decreased. Conclusions : This study suggests that Needle-Embedding Therapy is significantly effective on Dementia patients.

Effect of Hominis Placenta Pharmacopuncture for a Patient with Mild Cognitive Impairment: A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Trial

  • Kim, Yunna;Eom, Yoon Ji;Kwon, Dohyung;Lee, Jae Hyok;Jung, In Chul;Cho, Eun;Lee, Ji Eun;Cho, Seung-Hun
    • 동의신경정신과학회지
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    • 제32권2호
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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.

진정수면제를 음독한 노인 입원 환자에서 발생한 섬망에 대한 한의복합중재 증례보고 (Korean Medicine Treatments for Delirium in an Elderly Patient Caused by Sedative-Hypnotics Overdose)

  • 조한별;구병수;김근우
    • 동의신경정신과학회지
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    • 제34권4호
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    • pp.473-485
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    • 2023
  • Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative-hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

일개 보건소에서 시행한 독거노인 한방 가정방문 결과보고: 이침치료를 활용한 인지기능 개선을 중심으로 (Results of the Korean Medicine Visiting Care Service for Solitary Elderly in a Public Health Center)

  • 권찬영;이보람;정선용;김종우
    • 동의신경정신과학회지
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    • 제30권2호
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    • pp.47-58
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    • 2019
  • Objectives: To conduct and report the results of a public health promotion program in Korean medicine (KM), namely the KM Visiting Care Service for Solitary Elderly, from November 2018 to April 2019. Methods: Six elderly people living in a rural area received the KM visiting care service, twice a week, for four months. This service consisted of acupuncture, auriculotherapy, and supportive counseling to manage their musculoskeletal pain, cognitive impairment, and/or depression. The changes of symptoms were assessed using Numeric Rating Scale (NRS), Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Korean version of Montreal Cognitive Assessment (MoCA-K), and Geriatric Depression Scale-Short form Korean (GDS-SF-K). Results: Through the 4-months KM visiting care service, the overall subjects' NRS-rated pain decreased slightly. Most showed improvement in MMSE-DS and/or MoCA-K, except one subject who was diagnosed with Alzheimer's disease. Depression assessed by GDS-SF-K showed improvement in a few subjects who were unable to walk independently. Satisfaction assessed through survey was generally high in all subjects. Conclusions: This KM Visiting Care Service for Solitary Elderly may help improve the pain and cognitive function of frail solitary elderly in rural areas. However, the protocol need to be improved to optimize the effect.

교통사고로 인한 기억상실장애 환자 1례에 대한 증례 보고 (Clinical study on a case of a patient with memory disorders caused by traffic accident)

  • 이승기;최우진
    • 동의신경정신과학회지
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    • 제13권1호
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    • pp.117-125
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    • 2002
  • Objectives: The purpose of this study was to investigate the clinical application of oriental medical therapy to a patient with memory disorders and quadriparesis caused by traffic accident. Methods: This study was carried out on a patient who was admitted to the Sangji oriental medical hospital, from January 21st in 2002 to May 2nd in 2002. We used 4 kinds of diagnosis(watching, asking, hearing, and toughing) and treated the patient with herbal medication and acupuncture therapy. Then we estimated the effect of memory disorders through MMSE-K(Mini mental State Examination-Korea) and K-DRS(Korean-Dementia Rating Scale). The numerical effect demonstrated ability of movement through range of motion. Results: Following the treatment the patient's mental state and the ability of movement improved. Conclusions: The present results suggest that oriental medical therapy has the positive effects on a patient with memory disorders and quadriparesis which were caused by traffic accident.

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알츠하이머병 및 경도인지장애 환자에서 갑상선 관련 호르몬과 인지기능과의 상관관계 (Association between Thyroid-Related Hormones and Cognitive Function in Patients with Alzheimer's Disease and Mild Cognitive Impairment)

  • 박다윤;김현;이강준
    • 정신신체의학
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    • 제27권1호
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    • pp.60-68
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    • 2019
  • 연구목적 갑상선관련 호르몬과 인지기능의 상관 유무는 논란이 되고 있다. 알츠하이머병과 경도인지장애 환자에서 갑상선관련 호르몬 농도에 차이가 있는지 비교해 보고, 나아가 갑상선관련 호르몬 농도가 인지기능의 어떠한 영역과 관련이 있는지에 대해 연구해보고자 하였다. 방 법 2011년 1월부터 2018년 12월까지 기억력 저하를 주소로 일산백병원 정신건강의학과 치매클리닉을 방문하여 알츠하이머병(NINCDS-ADRDA 진단기준)과 경도인지장애(Petersen 진단기준) 으로 진단된 105명의 환자를 대상으로 한 후향적 연구이다. 갑상선관련 호르몬[삼요오드티로닌(Triiodothyronine, T3), 티록신(Thyroxine, T4), 갑상선 자극 호르몬(Thyroid stimulating hormone, TSH)]의 측정은 화학발광면역측정법을 사용하여 검사하였다. 알츠하이머병군과 경도인지장애군 간의 갑상선관련 호르몬의 평균치 분석을 위하여 독립표본 t-검정을 시행하였다. 갑상선관련 호르몬이 전반적 퇴화 척도(Global deterioration scale, GDS), 치매임상평가척도(Clinical dementia rating, CDR) 및 한국형 임상치매평가척도(The Korean version of the consortium to establish a registry for Alzheimer's disease, CERAD-K)의 각 항목 별 점수들과 유의한 상관이 있는지 알아보기 위하여 한국판 노인우울척도(Geriatric depression scale-Korean version, GDS-K)를 통제변수로하여 편상관분석을 시행하였다. 결 과 총 105명의 환자 중 알츠하이머병군은 74명, 경도인지장애군은 31명이었다. 알츠하이머병군과 경도인지장애군 간 혈청 T3, T4, TSH 농도의 평균은 모두 유의한 차이가 없었으나, CERAD-K 항목 중 구성행동 검사(Construction praxis test, CPT)가 혈청 TSH 농도와 유의한 양의 상관 관계를 보였다(p-value=0.004). 결 론 본 연구에서 실행기능과 연관된 CPT가 혈청 TSH 농도와 유의한 양의 상관 관계를 보인 것은 갑상선관련 호르몬과 치매의 병태생리와의 연관성에 대한 이해에 도움을 줄 수 있다고 생각한다. 향후 갑상선관련 호르몬이 인지기능에 미치는 병태생리 기전에 관한 전향적 연구들이 필요할 것으로 사료된다.

보행장애를 호소하는 약인성 파킨슨 증후군 환자의 한방복합치료 1례 (Case Report of Drug-Induced Parkinsonism with Gait Disturbance Treated with Adjuvant Korean Therapy)

  • 황예채;이혜진;허경화;허혜민;조승연;박정미;고창남;박성욱
    • 대한한방내과학회지
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    • 제44권2호
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    • pp.187-196
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    • 2023
  • Objective: This case study reported the effectiveness of adjuvant Korean therapy on gait disturbances induced by drug-induced Parkinsonism. Method: A patient suffering from frontotemporal lobe dementia was diagnosed with drug-induced Parkinsonism and treated with adjuvant Korean therapy, including herbal medicine and pharmaco-acupuncture. The evaluation was performed by monitoring the length of time and number of steps during an 8 m gait, using the Unified Parkinson's Disease Rating Scale (UPDRS). Results: After 17 days of adjuvant Korean therapy, the UPDRS score improved from 32 to 16. The length of time for the 8 m gait improved from 20 seconds to 14 seconds. The patient also showed a decrease in the number of steps during the 8 m gait from 43 to 22. Conclusion: This case suggests that adjuvant Korean therapy can be effective for drug-induced Parkinsonism.

알쯔하이머형 치매 환자에서 행동심리증상과 호모시스테인과의 연관 (Correlation of Behavioral and Psychological Symptoms and Homocysteine in Patients with Dementia of Alzheimer's Type)

  • 이지민;임우영;김현;이강준
    • 정신신체의학
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    • 제22권1호
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    • pp.23-30
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    • 2014
  • 연구목적 호모시스테인은 인지기능의 손상과 다양한 정신과 증상들과 연관되어 있다. 본 연구는 혈중 호모시스테인 농도와 치매의 행동심리증상 사이에 연관성을 검증하기 위해서 시행되었다. 방법 DSM-IV에 의해 알쯔하이머형 치매로 진단된 환자 41명의 혈중 호모시스테인, 엽산, 비타민 $B_{12}$ 농도를 측정하였다. 그리고 병력청취, 신체검사와 간이정신상태기능검사(MMSE), 전반적 퇴화척도(GDS), 임상치매 평가척도(CDR), 한국형 신경정신행동검사(K-NPI)를 수행하였다. 결과 호모시스테인 농도와 NPI 총 점수 사이에 통계적으로 유의한 양의 상관관계가 관찰되었고 망상, 초조/공격성, 우울/불쾌, 들뜸/흥분과 같은 여러 하위항목과도 양의 상관관계가 관찰되었다. 호모시스테인 농도와 MMSE, GDS, CDR 점수 사이에는 유의한 상관관계가 관찰되지 않았다. 결론 본 연구는 혈중 호모시스테인 농도가 치매의 행동심리증상과 연관되어 있음을 보여준다. 추가적인 연구를 통하여 이와 연관된 병태생리학적 기전을 밝히는 것이 필요하다.

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치매노인을 돌보는 가족의 부담감과 우울반응에 관한 연구 (A Study on the Burdens and Depressive Reactions on Families who Cared for Patients Suffering from Senile Dementia)

  • 김영자;이평숙
    • 대한간호학회지
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    • 제29권4호
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    • pp.766-779
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    • 1999
  • The purpose of this study was to investigate the relationship between the burden on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patient at home, and another 300 participants left 100 patient at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit (1980) tool was employed to measure the degree of burden and Zung's(1965) “Self-Rating Depression Scale” was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA and Person's Correlation Coefficient were calculated. The results are as follows : 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that care -giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F=2.48, P<.05), and the socio-economic status of the family(F=5.17, P<.05). Its also affected by the patient's educational status(F=2.17, P<.05). 4. The degree of depression of the family was significantly dependent on sex(t=-2.05, P<.05), age (F=2.99, P<.05), the relationship with the patient(F=3.65, P<.01), socio-economic status (F=7.74, P<.001), occupation(t=2.82, P<.01), health status(F=4.42, P<.01), and the place of residence(F=4.30, P<.01), The patient characteristics was significantly dependent on his/her educational status(F=3.85, P<.01), the period of suffering from senile dementia(F=2.47, P<.05), and smoking habit(F=6.17, P<.001). 5. The relationship between the degree of burden and that of depression reads r=0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-givers for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must be developed, and its clinical effect also has to be examined.

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