• Title/Summary/Keyword: Dementia, Vascular

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Vascular Dementia (혈관성 치매)

  • Kim, Tae Woo;Kwak, Kyung Phil
    • Korean Journal of Biological Psychiatry
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    • v.23 no.3
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    • pp.80-88
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    • 2016
  • Vascular dementia is a very frequent form of dementia. Debates over classification and diagnostic criteria, and controversy over identifiable treatment targets will continue until distinct pathophysiological mechanism of vascular dementia is found. Clinical diagnostic criteria are sufficiently strong to be useful for clinical trials, but need further refinement. Cognitive changes in vascular dementia are more variable than other disorders, and are dependent on the vascular pathology. Accurate diagnosis of vascular dementia is known to need the presence of reliable cerebrovascular disease on brain imaging. Although it seems obvious that cerebrovascular disease causes pathological damage and impaired cognition, it is very difficult to find the accurate contribution of cerebrovascular pathology to cognitive decline. Most studies have shown a small but significant benefit of cholinesterase inhibitors on cognition, the significance of this effect has been slight and benefits on global functioning, activities of daily living, and behaviour have not been consistently reported. Management of vascular dementia should focus on identifying and managing vascular risk factors.

Review of Clinical Trials about Herbal Medicine for Vascular Dementia (혈관성 치매 치료 한약물 임상연구 고찰)

  • Kim, Ka-Na;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.4
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    • pp.37-48
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    • 2012
  • Objectives : The purpose of this study is to investigate the frequently used herbal materials among herbal prescription for vascular dementia. Methods : Every article relevant to vascular dementia was initially obtained from a Korean database and PubMed. Keywords searched were 'vascular dementia', 'herbal medicine' and 'human'. Results : Clinical study, which vascular dementia were treated with herbal medicine, were 12. Among these 12 articles, 6 were case study, 1 was Controlled Clinical Trial and 5 were Ramdomized Controlled Trial (RCT). High frequently used herbal materials were Ginseng Radix (9 times), Cnidii Rhizoma (8 times), Glycyrrhizae Radix, Citri Pericarpium, Astragali Radix and Angelicae Gigantis Radix (6 times). Conclusions : We could know frequent-used herbal medicine for vascular dementia. To be aware of the frequently used herbal medicine for vascular dementia can be helpful in adding herbal materials to prescription in a clinical treatment and development of new drugs.

Intermittent Fasting: a Promising Approach for Preventing Vascular Dementia

  • Yoon, Gwangho;Song, Juhyun
    • Journal of Lipid and Atherosclerosis
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    • v.8 no.1
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    • pp.1-7
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    • 2019
  • Vascular dementia is the most common neuropsychiatric syndrome and is characterized by synaptic dysfunction, neuroinflammation, and cognitive dysfunction. Vascular dementia is associated with various environmental, genetic, and lifestyle risk factors. Recent research has focused on the association between vascular dementia and dietary patterns, suggesting that dietary regulation leads to better control of energy metabolism, improvements in brain insulin resistance, and the suppression of neuroinflammation. Intermittent fasting is a calorie-restriction method known to be more effective in promoting fat loss and regulating the impairment of glucose metabolism as compared with other dietary restriction regimens. Herein, the authors review the effects of intermittent fasting with regard to vascular dementia based on recent evidence and propose that intermittent fasting could be a therapeutic approach for ameliorating vascular dementia pathology and preventing its onset.

The literatual study on the cerebral vascular dementia in oriental and occidental medicine (뇌혈관성(뇌혈관성) 치매(痴?)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Ann, Tak-Weon;Hong, Seog;Kim, Hee-Chul
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.40-70
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    • 1996
  • In the literatual study on the cerebral vascular dementia, the results were as follows : 1. Cerebral vascular dementia is so called apoplectic dementia, because it almost occurs after apoplexy, the attack rate has gradually increased by increase of life, so it exert a harmful influence to geriatric diseases. 2. The etiological factors are summarized on deficiency in the heart, kidney, liver(心, 腎, 肝虛), pathogenic wind(豊) pathogenic fire(火) phlegm(痰) and stagnated blood(瘀血) in the oriental medicine, and multiple cerebral infarction, cerebral anemia, decrease of cerebral vascular flow are etiological factors in the occidental medicine. 3. The region of infarction and attack of cerebral vascular dementia have a close connection, and generally the cerebral vascular dementia easily occur in injury of white matter of brain. 4. Symptoms of cerebral vascular dementia are dysphasia, walking disorder, hemiplegia, sensory paralysis, disturbance of memory, judgement, calculation, emotion incontinence, speech impediment, silence or talkative, lower thinking ability and depersonalization, and symptoms are aggravated by stage. 5. Therapeutic herb medicines are Palpungsan(八風散), Baepungsan(排風散), Jinsaanshinhwan(辰砂安神丸), Sabacksan(四白散), Kanghwalyupungsan(姜活愈風散), Woohwangchungshimhwan(牛黃淸心丸), and they are used to dispelling pathogenic wind(祛風), soothe the nerves(安神), dispel pathogenic heat from lung, nourish the blood(淸肺養血).

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A clinical study of vascular dementia in stroke patients (중풍환자(中風患者)의 혈관성치매에 대한 임상적(臨床的) 관찰(觀察))

  • Kim Won-Chan;Kim Young-Suk;Moon Sang-Kwan;Ko Chang-Nam;Cho Ki-Ho;Bae Hyung-Sup;Lee Kyung-Sup;Park Jung-Mi
    • The Journal of Internal Korean Medicine
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    • v.19 no.2
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    • pp.50-59
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    • 1998
  • Background : Vascular dementia occurs mainly due to cerebral vascular disease. So we performed this clinical study to investigate the incidence and characteristics of vascular dementia in stroke patients. Methods : This study was performed on the patients hospitalized from April 1, 1998 to August 31, 1998 at the department of circulatory internal medicine, hospital of Oriental medicine, Kyung-Hee University, and diagnosed cerebral infarction or hemorrhage by Brain CT or MRI. we devided the patients into two groups; vascular dementia group and non dementia group according to MMSE-K(Mini Mental State Examination Korean version), Hasegawa dementia scale. Patients were diagnosed dementia using DSM-IV. We compared general characteristics, stoke types and laboratory findings between the two groups and investigated the correlationship between MMSE-K and Hasegawa dementia scale. Results : Results showed that the incidence of vascular dementia was about 27.8% in stroke patients. The greater number of subjects with dementia were women in the lower educational classes and had lower MBI(Moderfied Bathel Index) scores. Vascular dementia were more common in patients with large brain lesion size($>20cm^3$). There was a positive correlationship between Hasegawa scores and MMSE-K.

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Three Case Reports about Improving Vascular Dementia and Secondary Dementia (혈관성 치매와 속발성 치매 치험 및 호전 3례)

  • Yun Kyoung-Sun;Lee Ji-Hun;Kim Jae-Woo;Jeong Sung-Hyun;Shin Gil-Cho;Lee Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1103-1111
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    • 2003
  • Dementia is classified into Alzheimer's disease, vascular dementia and secondary dementia by its causes. Alzheimer's disease is hard to expect cognitive improvement, whereas vascular dementia and secondary dementia are reversible by medical treatments Dementia can be categorized as Chi-Mae(痴?), Geon-Mang(健忘), Huh-Ro(虛勞), Guang(狂), in the oriental medicine and treated by 'purgation therapy' when it is classified into excessive syndrome. We observed some significant improvements in the cognitive function from three patients diagnosed vascular dementia and secondary dementia by herbal medications of $\ulcorner$Dong-Eui-Su-Sheh-Bo-Won(東醫壽世保元)$\lrcorner$. We report the process of the treatment.

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A Interpretation of Vascular Dementia through Three Yin & Three Yang to Study on the Acupuncture Treatment (혈관성 치매의 육경적(六經的) 해석(解釋)및 침구(鍼灸) 치료(治療)의 방향(方向)에 관(關)한 소고(小考))

  • Lee, Bong-Hyo;Jeon, Won-Kyung;Han, Chang-Hyun
    • Korean Journal of Acupuncture
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    • v.28 no.4
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    • pp.169-175
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    • 2011
  • Objectives : The aim of this study is to find a desirable way for acupuncture treatment of Vascular Dementia. Methods : The author reviewed several literatures related with Vascular Dementia. Based on the literatures, the author interpreted the causes and symptoms of Vascular Dementia on viewpoint of three yin and three yang. In addition, research about desirable way for acupuncture treatment was carried out. Results and Conclusions : The cause of Vascular Dementia is thought to be the functional weakness of lesser yin, the heart meridian. Also, the related-factors represent functional excess of reverting yin and greater yin, as well show functional weakness of lesser yin. Accordingly, for the acupuncture treatment of Vascular Dementia, it is necessary to tonify lesser yin. On the other hand, the activation of lesser yang is thought to be helpful.

치매에 대한 한의학적 임상연구

  • Whang Wei-Wan;Kim Jong-Woo;Lee Jo-Hee;Eom Hyo-Jin;Lee Seung-Gi
    • Journal of Oriental Neuropsychiatry
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    • v.7 no.1
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    • pp.1-13
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    • 1996
  • 1. Out of 21 examples on a clinical base Alzheimer type dementia were 8 examples(38%), 11 vascular types(52%), 1 Alzheimer and vascular mixed type and rest 1 was secondary dementia type(NPH).2. Between the genders, there were 5 males and 3 females for Alzheimer types, 6 males and 5 females for the vascular types, 1 male for Alzheimer and vascular mixed type, and 1 female for secondary dementia type(NPH).3. For the degrees of Alzheimer type dementia there were 2 mild dementia, 4 moderate dementia, and 2 severe dementia. 4. Among the Alzheimer types 2 mild dementia were almost recovered back to normal in approximately 2 months, 2of 4 moderate dementia became significantly better in approximately 2 months and recovered to almost normal state in 3 to 5 months. The rest 2 have been under treatment for 3 months, but showed a little improvement. Out of 2 severe dementia examples, one showed a little improvement even if it has been under treatment over 2 years. The other example did not show any improvement, but dementia did not proceed any more.5. Among the 11 vascular examples, 7 recovered in 2 to 3 months, 1 in 5 months, 2 recovered in a year, and the treatment was stopped arbitrary for the last one.6 In the case of Alzheimer and vascular mixed type dementia, even the moderate dementia did not show any apparent result in 6 months.7. For NPHI (Normal Pressure Hydrocephalus), there was an improvement on dementia in 2 months after the treatment, but gait disturbance and urinary incontinence did not show any noticeable difference. As a conclusion, almost all the Alzheimer and vascular type patients recovered, but the treatment periods varied depending on the types of the dementia and the degree of seriousness, especially in the case of the severe Alzheimer patients, the treatment oniy suppression the progression of the dementia. The most important aspect from clinical point of view was even if almost all the patients were almost completely cired, they need to keep being cured for a long period of time. The method with respect to Four Constitutions is thought of the most desirable.

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Cases Report about Vascular Dementia Treated with Bojungikki-tang-gamibang (보중익기탕가미방을 투여한 혈관성 치매 환자 증례군 보고)

  • Kim, Dae-Jun;Park, Mee-Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.1
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    • pp.144-148
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    • 2011
  • The purpose of this case series was to investigate the effectiveness of Bojungikki-tang-gamibang for vascular dementia. The case subjects were nine patients who were diagnosed as vascular dementia by Mini-Mental State Examination-Korean (MMSE-K) and Hachinski's ischemic score. They were inpatients at the Kumi Oriental Medical Hospitalof Daegu Haany University from February in 2008 to Aprile in 2009. They were treated with Bojungikki-tang-gamibang. Results of before and after therapy were evaluated and scored using Korean-version Dementia Rating Scale (K-DRS). The results were analyzed using statistical methods, such as Wilcoxon signed rank test and Mann-Whitney U test. The study showed that the K-DRS score significantly increased after treatment (P<0.05). In summary, this cases report suggests that Bojungikki-tang-gamibang appears to be effective in the treatment of vascular dementia.

A Case Study on Drug Prescription for Vascular Dementia in Western and Oriental Medicine (혈관성치매에 대한 한.양방 치료약물의 처방 사례연구)

  • Choi, Seong-Hun;Cheon, Woo-Hyun;Baek, Kyung-Min;Han, Chang-Hyun;Jeon, Won-Kyung;Gam, Cheol-Ou;Lee, Young-Joon
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.3
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    • pp.39-49
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    • 2011
  • Objectives : Vascular dementia is the second common cause of dementia after Alzheimer's disease. It assumed that the ratio of prescription drugs on vascular dementia are quite different from each hospital in Western medicine or Oriental medicine, respectively. The aim of this research is to collect and analyze the ratio of prescription drugs on vascular dementia in Western medicine or Oriental medicine in university hospitals. Methods : We collected and analyzed the data related to prescriptions on vascular dementia in the department of neurology in three university hospitals(A, B, C) and in the department of internal medicine in two Oriental medicine hospitals(Daegu Haany Oriental Hospital, Dong Eui Oriental Hospital). Results : In the department of neurology in A university hospital, donepezil(69.1%), memantine(14.0%), rivastigmine(12.3%), galantamine(4.5%) were prescribed in order. In B university hospital, galantamine(57.8%) donepezil(33.3%), rivastigmine(6.7%), donepezil with memantine(4.4%) were prescribed. In C university hospital, donepezil(62.0%), rivastigmine(25.0%), galantamine(7.0%) memantine(6.0%) were prescribed. The average frequencies of prescribed medication in the department of neurology in A, B, C university hospitals were donepezil(54.8%), galantamine(23.1%), rivastigmine(14.7%), memantine(7.4%). In Oriental medicine hospitals, various prescriptions have been used for vascular dementia. Among them, Ansincheongnoetang (安神淸腦湯) and Gamijihangeumja(加味地黃飮子) were often prescribed in Daegu Haany Oriental Hospital, and Bojungikgitang(補中益氣湯) in Dong Eui Oriental Hospital, too. Conclusions : Cholinesterase inhibitors such as donepezil, galantamine, rivastigmine and NMDA receptor inhibitor like memantine have been used as a drug of choice for vascular dementia in all surveyed university hospitals. In oriental hospitals, various prescriptions have been used for vascular dementia.