• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.205-212
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• 2018

Background: Brain volume is associated with dementia and depression in the elderly. An easy way to predict relative brain volume is to measure head circumference. In this study, we investigated the relationship between head circumference and cognition as well as depression in a non-demented elderly community. Methods: Baseline and follow-up surveys were conducted in 2007 and 2010. At baseline, community residents aged 65 years or over (n=382) within a rural area of South Korea were screened for dementia and symptoms of depression and were followed using the same screening battery after 3 years (n=279). Data from anthropometric measurements (head circumference, height, and body weight), demographics, and blood tests were gathered. Neuropsychological tests, including the Korean version of mini-mental state examination (K-MMSE), clinical dementia rating (CDR) including the CDR-sum of boxes, the Korean version of instrumental activities of daily living, and geriatric depression scale (GDS), were performed. None of the 279 subjects followed were demented. Results: Baseline performance on the K-MMSE and GDS was poorer for participants with smaller head circumferences. Follow-up performance on the MMSE was also poorer for participants with smaller head circumferences. Interestingly, participants with smaller head circumference showed worse GDS scores at baseline but on follow-up examination, participants with larger head circumference showed rapid worsening than those with smaller head circumference with marginal significance by ANOVA test. In regression coefficient analysis, GDS decline showed significant difference. Conclusion: Head circumference was not associated with cognitive change but was associated with symptoms of depression in non-demented community residents.

• 한국임상보건과학회지
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• 제4권3호
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• pp.603-614
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• 2016

Purpose. The purpose of this study was to provide basic data regarding the intention to use community care service based on special grading for dementia in the South Korean Society. Methods. A survey was conducted using a questionnaire adapted on the basis of literature review regarding the first to fourth grade under the long-term care insurance system for the aged from May 1 to 30, 2015 and a total of 272 questionnaires were statistically processed using SPSS 21.0. Frequency analysis, descriptive statistics, and cross-tabulation analysis were performed. The non-parametric type of test, ${\chi}^2$ test, was used for statistical testing. Results. This study obtained the following results: First, caregivers had greater intention to ask recipients to use daytime and nighttime care service. Second, there were statistically significant differences in caregivers' education, occupation, monthly average income, co-residence status, intimacy, and care-giving burden (emotional, financial, and social) and recipients' activities of daily living, instrumental activities of daily living, mental health status, dementia status, and intention to use community care service based on special grading for dementia. Conclusions. There are very few statistical data and academic materials regarding special grading for dementia, which has recently been established. The results of this study are therefore expected to help make a systematic analysis of the intention to use community care service by caregivers based on special grading for dementia.

• 생물정신의학
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• 제27권2호
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• pp.94-100
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• 2020

Objectives Amyloid β positron emission tomography (Aβ PET) is widely used as a diagnostic tool in patients who have symptoms of cognitive impairment, however, this diagnostic examination is too expensive. Thus, predicting the positivity of Aβ PET before patients undergo the examination is essential. We aimed to analyze clinical predictors of patients who underwent Aβ PET retrospectively, and to develop a predicting model of Aβ PET positivity. Methods 468 patients who underwent Aβ PET with cognitive impairment were recruited and their clinical indicators were analyzed retrospectively. We specified the primary outcome as Aβ PET positivity, and included variables such as age, sex, body mass index, diastolic blood pressure, systolic blood pressure, education, dementia family history, Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Box (CDR-SB), hypertension (HTN), diabetes mellitus (DM) and presence of apolipoprotein E (ApoE) E4 as potential predictors. We developed three final models of amyloid positivity prediction for total subjects, mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using a multivariate stepwise logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) value was calculated for the ROC curve. Results Aβ PET negative patients were 49.6% (n = 232), and Aβ PET positive patients were 50.4% (n = 236). In the final model of all subjects, older age, female sex, presence of ApoE E4 and lower MMSE are associated with Aβ PET positivity. The AUC value was 0.296. In the final model of MCI subjects (n = 244), older age and presence of ApoE E4 are associated with Aβ PET positivity. The AUC value was 0.725. In the final model of AD subjects (n = 173), lower MMSE scores, the presence of ApoE E4 and history of HTN are associated with Aβ PET positivity. The AUC value was 0.681. Conclusions The cerebral amyloid positivity model, which was based on commonly available clinical indicators, can be useful for prediction of amyloid PET positivity in MCI or AD patients.

• 지역사회간호학회지
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• 제19권1호
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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.

• Parasites, Hosts and Diseases
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• 제60권5호
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• pp.353-355
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• 2022

We report a case of an 80-year-old Korean man with chronic cerebral paragonimiasis who presented with progressive memory impairment. He suffered from pulmonary paragonimiasis 60 years ago and has been experiencing epilepsy since the age of 45. He began experiencing memory and cognitive deterioration 3 years ago. He visited the neuropsychiatric department of our hospital to check his symptoms and health from a year ago. Contrast-enhanced brain magnetic resonance imaging study revealed calcifications and cystic lesions encompassing the right temporo-occipital region. Encephalomalatic changes were also observed in the right occipital and temporal areas. The anti-Paragonimus specific IgG antibodies in his serum showed a strong positive response. The neuropsychological test results showed a Global Deterioration Scale of 4 and a Clinical Dementia Rating Scale of 1. The chronic cerebral paragonimiasis lesions in the patient's right temporo-occipital region might induce the dementic change.

• 동의신경정신과학회지
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• 제17권1호
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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.

• 한국엔터테인먼트산업학회논문지
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• 제15권1호
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• pp.181-189
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• 2021

본 연구는 알츠하이머 치매 환자의 MMSE-K, SGDS, NPI-Q, BADL IADL CDR 평가도구 결과를 분석하여 치매평가 도구들 간의 상관관계와 치매중등도 판정에 미치는 영향정도를 확인하고자 하였다. 본 연구는 일개 병원의 알츠하이머대상자의 치매검사자료인 2차 자료를 분석한 서술적 조사 연구이다. 본 연구는 2015년 1월부터 2017년 4월까지 일개 치매검진병원에서 등록 관리되고 있는 알츠하이머 치매 환자 총 617명의 자료를 분석하였으며, 수집된 자료는 SPSS 25.0 통계 프로그램을 이용하여 분석하였다. 치매평가도구 중 치매중등도 판정에 영향력이 큰 유의한 도구로는 CDR, ADL, MMSE-K, SGDS 도구이며, 유의한 영향을 미치지 못하는 도구로는 NPI-Q, IADL로 나타났다.

• 대한치매학회지
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• 제17권3호
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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.

• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.313-321
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• 2002

Objectives : To identify the risk factors of dementia among the elderly in a large city. Methods : A cross-sectional study was conducted in July 2001, with potential participants selected by stratified two stage cluster sampling of the elderly population of Keumgog dong, Busan. A total of 452 elderly people aged 65 years and over, underwent a two phase diagnostic procedure. Mini-mental State Examination-Korean (MMSE-K) and Samsung Dementia Questionnaire were used for the 1st stage, and the Clinical Dementia Rating Scale (CDR), the Bartel ADL, and IADL Index, the Korean Geriatric Depression Scale (KGDS), the Modified Hatchinski Ischemic Scale (MHIS), and other laboratory tests were used for the 2nd stage. Results : Of the 446 participants finally chosen, 45 were confirmed with dementia, and 363 as normal, with the rests not confirmed with dementia or as normal, were excluded from the analysis. According to the logistic regression analysis, the risk of dementia was significantly higher In: people aged 80 and above (OR=4.36, 95% CI=1.97-9.62), illiterate (OR=3.58, 95% CI=1.71-7.46), who had a history of strokes (OR=6.35, 95% CI=2.71-14.87), or who had 3 history of hyperlipidemia (OR=4.74, 95% CI=1.65-13.61), compared to their counterparts. Conclusions : These results suggest that efforts to prevent strokes and hyperlipidemia can significantly decrease the risk of dementia.

• 대한약침학회지
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• 제22권4호
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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.