• 한국노년학
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• 제40권2호
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• pp.325-340
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• 2020

치매 증상의 진행 지연 및 관리비용의 절감을 위해서는 치매를 조기에 발견하여 관리하는 것이 중요하다. 이에 본 연구에서는 치매와 관련된 인지신경학적 손상을 측정할 수 있는 간단한 그림검사인 도형모사검사를 개발하여, 치매 선별 가능성을 확인하고자 하였다. 또한, 도형모사검사의 이미지 데이터에 대한 기계학습을 통해 검사 채점의 자동화 가능성을 확인하고자 하였다. 이를 위해 270명의 일반 및 손상집단 참가자들에 대하여 도형모사검사, MMSE-DS, 그리고 시계그리기 검사를 수행하였다. 분석 결과, 도형모사검사의 점수는 높은 내적 일치도를 보였을 뿐만 아니라, 다른 두 검사 점수와 유의한 상관을 보여 검사의 타당성을 확인하였다. 세 검사의 치매 선별 정확도를 비교하기 위해 판별분석을 시행한 결과, 다른 두 검사와 비교했을 때 도형모사검사가 일반 및 손상 집단을 각각 90.8% 및 77.1%의 정확도로 예측하여, 집단에 대한 예측 수준이 상대적으로 더 높은 것으로 나타났다. 또한, 신경과 진단을 통한 임상 결과를 통해, MMSE-DS를 통해 선별하지 못했던 치매 사례들을 도형모사검사를 이용하여 선별할 수 있음을 확인하였다. 마지막으로, 도형모사검사의 이미지 데이터를 이용한 기계학습을 수행한 결과, 73.70%의 정확률로 집단을 예측하는 것을 확인하였다. 본 연구는 기존에 사용되어 온 치매 선별 검사의 한계를 보완하여, 시행과 채점이 간편한 새로운 그림검사를 개발하였다는 점에서 의의를 지닌다.

• 동의신경정신과학회지
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• 제32권3호
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• pp.285-302
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• 2021

Objectives: To examine the effect of long-term Korean medicine treatment on mild cognitive impairment (MCI). Methods: This study was conducted on two patients who were diagnosed with mild cognitive impairment and received long-term Korean medicine treatment. In order to evaluate the degree of cognitive decline, SNSB and K-MMSE were performed 2~3 times at the first visit and during the treatment process. Results: Both cases 1 and 2 were diagnosed with MCI with a high possibility of developing dementia. In case 1, MCI progressed to early dementia at one year after the diagnosis of MCI. However, in case 2, that MCI status was maintained without progressing to dementia for 4 years after the diagnosis of MCI. The cause of such difference in the course of MCI might be attributed to the fact that Case 1 had lower K-IADL level but higher SGDS level than Case 2 at the time of initial diagnosis, with weak family support and irregular herbal medicine intake. Conclusions: Korean medicine treatment could improve and manage symptoms of cognitive decline due to MCI.

• 한국산학기술학회논문지
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• 제15권6호
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• pp.3832-3840
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• 2014

고령화 사회로 급격히 진행 함에 따라 치매 환자 또한 급속히 증가하고 있으나 진행이 되면 완치가 어려운 실정이다. 초기에 발견하고 진행 과정을 늦추는 것이 치료의 목표이고 환자의 안전, 지속적인 보살핌, 일상 생활, 건강 관리지원이 중요하다. 본 논문의 스마트 케어 시스템은 동작 감지 센서, 가스 누출 감지 센서를 활용한 블루투스 통신 기술을 사용하여 화재, 가스 누출, 가출시 배회등의 각종 응급 상황에 대처 할 수 있게 해주고, 스마트폰을 통해 환자의 일상 생활 수행능력을 지속적으로 관찰, 관리 함으로써 한국의 효 문화의 특성상 환자가 입원 전 가정에 더 오래 머물 수 있도록 하면서도 치매 환자의 부양자들이 갖는 경제적, 신체적, 심리적 부양 부담을 줄일 수 있다. 시스템 내에서 축적된 개인별 데이터베이스는 전문의에게 상담, 치료 가능하며 전문 치료 기관 및 복지 시설과의 연계를 통한 전문 서비스를 지원 받을 수 있다.

• 대한치매학회지
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• 제17권4호
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• pp.163-173
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• 2018

Background and Purpose: Behavioral variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia, which has clinical symptoms of progressive personality and behavioral changes with deterioration of social cognition and executive functions. The pathology of bvFTD is known to be tauopathy or TDP-43 equally. We analyzed the $^{18}F-THK5351$ positron emission tomography (PET) scans, which were recently developed tau PET, in patients with clinically-diagnosed bvFTD. Methods: Forty-eight participants, including participants with behavioral variant frontotemporal dementia (bvFTD, n=3), Alzheimer's disease (AD, n=21) and normal cognition (NC, n=24) who completed 3T magnetic resonance images, $^{18}F-THK5351$ PET scans, and detailed neuropsychological tests were included in the study. Voxel-wise statistical analysis and region of interest (ROI)-based analyses were performed to evaluate the retention of THK in bvFTD patients. Results: In the voxel-based and ROI-based analyses, patients with bvFTD showed greater THK retention in the prefrontal, medial frontal, orbitofrontal, anterior cingulate, insula, anterior inferior temporal and striatum regions compared to NC participants. Left-right asymmetry was noted in the bvFTD patients. A patient with extrapyramidal symptoms showed much greater THK retention in the brainstem. Conclusions: The distribution of THK retention in the bvFTD patients was mainly in the frontal, insula, anterior temporal, and striatum regions which are known to be the brain regions corresponding to the clinical symptoms of bvFTD. Our study suggests that $^{18}F-THK5351$ PET imaging could be a supportive tool for diagnosis of bvFTD.

• 동의신경정신과학회지
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• 제34권3호
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• pp.275-305
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• 2023

Objectives: This study aimed to review clinical and experimental studies using Korean traditional herbal medicine for dementia on the improvement of cognitive function and changes in gut microbiota. Methods: We searched 12 databases for clinical and experimental studies on the effect of Korean traditional herbal medicine treatment for dementia on changes in gut microbiota. Sample sizes, dementia types, diagnosis criteria, interventions, outcomes, and results, including changes in gut microbiota, were extracted from the included clinical studies and analyzed. Subjects, interventions, outcomes, and results, including gut microbiota changes, were extracted from the included experimental studies and analyzed. Results: A total of 22 studies were selected, and most of them were experimental studies. Improvement in cognitive function and changes in gut microbiota were reported in all studies. The most frequently used herbal material was Poria cocos, and the most frequently used prescription was Danggwijagyak-san and Chilseong-hwan. Lactobacillus, Firmicutes, Bacteroidetes, and Proteobacteria were frequently assessed gut microbiota. Conclusions: These results suggest the treatment potential of Korean traditional herbal medicine for dementia by regulating gut microbiota. However, there were discrepancies related to changes in gut microbiota among studies. Therefore, further studies are needed to clarify the effect and mechanism of Korean traditional herbal medicine for dementia on gut microbiota.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.306-316
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• 1999

Objectives: In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. Methods: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase 1,356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and feinted Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. Results: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12,8%(age-adjusted rate: 13,0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.0-10.4%]), The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. Conclusions : These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.

• 한국산학기술학회논문지
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• 제19권10호
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• pp.263-271
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• 2018

본 연구의 목적은 치매 가정체험프로그램 관람이 치매 인식 개선에 효과가 있는지 알아보고자 한 것이며, 치매 가정체험프로그램 관람에 대한 만족도와 전시관을 관람 한 후 치매에 관한 인식도 변화를 살펴보았다. 2018년 4월 5일부터 5월 25일까지 S시에 거주하는 주민 52명을 대상으로 연구가 진행되었다. 치매 가정체험프로그램은 현관, 화장실, 거실, 주방 각 공간들에 필요한 복지용구 등이 비치되어 구성되었으며, 가상현실 체험 프로그램과 노인 체험복 착용 프로그램들이 함께 진행되었다. 연구 결과 치매 가정체험프로그램 관람 만족도는 전반적으로 높은 것으로 나타나 치매 가정체험프로그램 관람이 치매 인식 개선에 교육적으로 효과가 있었음을 알 수 있었으며, 치매의 원인, 역학 및 제도, 증상 및 진단, 치료 및 예방에 대한 인식을 묻는 문항의 점수가 전시관 관람 후 눈에 띄게 상승함을 알 수 있었다. 그리고 대상자의 연령이 중년 이상인 경우 치매정보제공 및 예방법 소개, 안전하고 편안한 가정환경 조성방법 소개, 체험 프로그램의 적절성 등에서 만족도가 다른 연령대 보다 높게 나타났다. 본 연구에서는 기존에 없었던 차별화된 체험 프로그램을 통해 대상자의 참여를 적극적으로 유도하고, 단시간에 높은 교육 만족도를 끌어냈다는 점에서 긍정적인 결과를 보였다. 추후 더욱더 확장된 체험 프로그램을 만들고, 치매를 간접적으로 접할 수 있는 환경을 제공하며, 시민들이 더 많은 관심을 가질 수 있도록 지속적인 프로그램 진행이 이루어져야 할 것이다.

• Korean Journal of Radiology
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• 제22권5호
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• pp.770-781
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• 2021

Objective: Chemical exchange-dependent saturation transfer (CEST) MRI is sensitive for detecting solid-like proteins and may detect changes in the levels of mobile proteins and peptides in tissues. The objective of this study was to evaluate the characteristics of chemical exchange proton pools using the CEST MRI technique in patients with dementia. Materials and Methods: Our institutional review board approved this cross-sectional prospective study and informed consent was obtained from all participants. This study included 41 subjects (19 with dementia and 22 without dementia). Complete CEST data of the brain were obtained using a three-dimensional gradient and spin-echo sequence to map CEST indices, such as amide, amine, hydroxyl, and magnetization transfer ratio asymmetry (MTR_asym) values, using six-pool Lorentzian fitting. Statistical analyses of CEST indices were performed to evaluate group comparisons, their correlations with gray matter volume (GMV) and Mini-Mental State Examination (MMSE) scores, and receiver operating characteristic (ROC) curves. Results: Amine signals (0.029 for non-dementia, 0.046 for dementia, p = 0.011 at hippocampus) and MTR_asym values at 3 ppm (0.748 for non-dementia, 1.138 for dementia, p = 0.022 at hippocampus), and 3.5 ppm (0.463 for non-dementia, 0.875 for dementia, p = 0.029 at hippocampus) were significantly higher in the dementia group than in the non-dementia group. Most CEST indices were not significantly correlated with GMV; however, except amide, most indices were significantly correlated with the MMSE scores. The classification power of most CEST indices was lower than that of GMV but adding one of the CEST indices in GMV improved the classification between the subject groups. The largest improvement was seen in the MTR_asym values at 2 ppm in the anterior cingulate (area under the ROC curve = 0.981), with a sensitivity of 100 and a specificity of 90.91. Conclusion: CEST MRI potentially allows noninvasive image alterations in the Alzheimer's disease brain without injecting isotopes for monitoring different disease states and may provide a new imaging biomarker in the future.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 춘계학술대회
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• pp.12-14
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• 2022

인구 고령화와 더불어 최근 10년간 치매, 경도인지장애(MCI, Mild Cognitive Disorder) 수진자 수가 19배 수준으로 급증하면서 심각한 사회·경제적 문제로 대두되고 있다. MCI는 조기 진단 및 중재를 통해 치매 예방 가능성이 가장 큰 단계이지만, 국내 치매안심센터의 물리적 수용 한계 및 팬데믹으로 인한 대면 프로그램의 중단으로 MCI 및 치매 환자의 대응이 어려운 실정이다. 본 연구에서는 향후 급증하는 노인인구와 치매 환자를 위한 인지훈련 콘텐츠의 특성을 알아보고, 고령자의 인지, 신체, 사회기능을 효과적으로 훈련할 수 있는 XR(Extended Reality) 기반의 콘텐츠 개발 고려사항을 도출하고 이를 위한 디자인 요소를 제안한다.

• 대한간호학회지
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• 제48권5호
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• pp.601-621
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• 2018

Purpose: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. Methods: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). Results: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. Conclusion: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.