• Korean Journal of Radiology
• /
• 제22권5호
• /
• pp.770-781
• /
• 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
• /
• 한국정보통신학회 2022년도 춘계학술대회
• /
• pp.12-14
• /
• 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.

• 가정간호학회지
• /
• 제2권
• /
• pp.19-34
• /
• 1995

The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

• 디자인융복합연구
• /
• 제13권2호
• /
• pp.143-164
• /
• 2014

본 연구는 우리나라 인구의 고령화에 따라 노인뿐 아니라 치매를 가진 노인이 증가하는 것에 주목하고, 이에 예비 노인 세대가 치매를 자가 진단할 수 있는 태블릿 PC용 어플리케이션을 설계할 것을 목표로 하였다. 주로 노년기에 나타나는 치매는 정상적인 노화와 달리, 뇌 기능이 손상되면서 기억력, 언어 능력, 판단력 등 인지기능 전반에 걸쳐 장애를 보이는 것으로, 일반적으로 치매 환자는 언어 능력의 손상으로 의사소통 장애를 겪게 된다. 이에, 본 연구는 치매 환자의 문장이해 능력이 정상 노인에 비해 저하되어 있는 점에 주목하고, 이를 평가한 연구 결과를 참조하여 문장이해능력 평가 도구를 치매의 진단에 활용하고자 어플리케이션의 기능으로 적용하였다. 이 때, 어플리케이션에의 적용을 위해 본교 언어병리학과 신경언어장애연구실과 협력하여 새로운 문장이해능력 평가 도구를 제작하였으며, 우리나라의 예비 노인 세대로서 우리나라 뉴 실버세대(New Silver)를 어플리케이션의 타깃 사용자로 정의하였다. 이후 실제 타깃 사용자를 대상으로 사용성 평가를 수행하여, 어플리케이션의 활용 가능성 및 그 효용적 가치를 검토하였다. 그 결과, 사용자가 스스로 어플리케이션의 기능을 실행할 수 있고 사용하기 쉽다는 평가를 얻었으며, 이를 치매의 자가 진단에 활용할 수 있을 것이라는 결론을 도출하였다. 본 연구를 통해 치매 자가 진단을 원하는 뉴 실버세대 사용자가 어플리케이션을 활용하여 혼자서도 간편하게 치매를 진단하는 것이 가능하며, 나아가 이들의 치매 조기 발견 및 예방에 기여할 수 있을 것으로 기대한다.

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

• 대한한의학회지
• /
• 제40권1호
• /
• pp.46-62
• /
• 2019

Objectives: This study was made by Chung Yeon Korean Medicine Hospital in order to perform appropriate East-West integrative medicine. The purpose of this manual is to support decision-making and communication in the implementation of the East-West cooperative treatment of vascular dementia. Methods: In order to carry out this study, it is based on search terms such as 'vascular dementia', 'acupuncture', 'herbal medicine', 'integrative medicine', 'chinese traditional medicine', and 'cognitive function' in databases such as MEDLINE, EMBASE, OASIS and CNKI We collected references. The drafting proceeded with the collaboration of two specialists of the Korean medicine, and the disagreement on the basis of the quotation was determined through a two person agreement. After, The draft was reviewed by a western medical doctor(rehabilitation specialist). Then, The opinions of the entire medical staff of the committee were reflected in the draft and finalized the agreement. Results: Through this study, manuals for diagnosis, treatment, and other considerations in the process of applying East-West integrative medicine to vascular dementia were derived. Conclusions: This study has significance in that it provides manual information about the decision structure, treatment contents, role distribution, etc. of East-West integrative medicine within the medical institution that conducts the vascular dementia consultation. In order for this study to function as a generalized medical guideline, it is necessary to improve the research methodology and carry out professional consensus procedures.

• 대한치매학회지
• /
• 제22권4호
• /
• pp.121-129
• /
• 2023

Background and Purpose: As it becomes an aging society, interest in senile diseases is increasing. Alzheimer's dementia (AD) and osteoporosis are representative senile diseases. Various studies have reported that AD and osteoporosis share many risk factors that affect each other's incidence. This aimed to determine if active medication treatment of AD could affect the development of osteoporosis. Methods: The Health Insurance Review and Assessment Service provided data consisting of diagnosis, demographics, prescription drug, procedures, medical materials, and healthcare resources. In this study, data of all AD patients in South Korea who were registered under the national health insurance system were obtained. The cohort underwent conversion to an Observational Medical Outcomes Partnership-Common Data Model version 5 format. Results: This study included 11,355 individuals in the good persistent group and an equal number of 11,355 individuals in the poor persistent group from the National Health Claims database for AD drug treatment. In primary analysis, the risk of osteoporosis was significantly higher in the poor persistence group than in the good persistence group (hazard ratio, 1.20 [95% confidence interval, 1.09-1.32]; p<0.001). Conclusions: We found that the good persistence group treated with anti-dementia drugs for AD was associated with a significant lower risk of osteoporosis in this nationwide study. Further studies are needed to clarify the pathophysiological link in patients with two chronic diseases.

• BMB Reports
• /
• 제53권1호
• /
• pp.47-55
• /
• 2020

Alzheimer's disease (AD) is a multifactorial neurodegenerative disease and has become a major socioeconomic issue in many developed countries. Currently available therapeutic agents for AD provide only symptomatic treatments, mainly because the complete mechanism of the AD pathogenesis is still unclear. Although several different hypotheses have been proposed, mitochondrial dysfunction has gathered interest because of its profound effect on brain bioenergetics and neuronal survival in the pathophysiology of AD. Various therapeutic agents targeting the mitochondrial pathways associated with AD have been developed over the past decade. Although most of these agents are still early in the clinical development process, they are used to restore mitochondrial function, which provides an alternative therapeutic strategy that is likely to slow the progression of the disease. In this mini review, we will survey the AD-related mitochondrial pathways and their small-molecule modulators that have therapeutic potential. We will focus on recently reported examples, and also overview the current challenges and future perspectives of ongoing research.

• 대한치매학회지
• /
• 제23권1호
• /
• pp.54-66
• /
• 2024

Background and Purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography (¹⁸F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of ¹⁸F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, ¹⁸F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions: ¹⁸F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.

• 대한치과보철학회지
• /
• 제58권3호
• /
• pp.193-200
• /
• 2020

목적: 대규모 인구집단데이터를 사용하여 양측 또는 편측 완전 무치악 여부와 치매와의 관련성에 대하여 알아본다. 재료 및 방법: 만 60세 이상을 대상으로 구축된 건강보험공단 노인 코호트 데이터베이스를 사용하여 후향적 코호트 연구를 설계하였다. 실험군은 완전 무치악 코호트로 2012년 7월 1일부터 2013년 12월 31일 까지 1개 이상의 상악 또는 하악 레진상 완전의치 보험 처방 이력이 있는 사람을 대상으로 하였고, 대조군은 유치악 코호트로 같은 기간 동안 잔존치아에 대한 보존적 치아 처치 이력이 있는 사람을 대상으로 하였다. 모든 대상자들은 이 기간 동안 치매로 진단 또는 치료 받은 기록이 없었다. 성향점수매칭법에 따라 연령과 성별, 그리고 거주지역을 고려하여 실험군과 대조군을 1:1 동수로 매칭하였고, 두 코호트 집단간 2년 동안 치매로 이환된 비율을 비교하였다. 결과: 실험군과 대조군을 비교했을 때, 실험군인 양측 또는 편측 완전 무치악 환자에서 치매 발병률(12.13%)은 대조군인 유치악 환자의 치매 발병률(9.74%) 보다 유의미하게 높다는 것을 확인할 수 있었다 (P < .05). 다른 요인들과 치매와의 명확한 관련성은 확인되지 않았다. 결론: 대규모 인구집단데이터 분석을 통해 양측 또는 편측 완전 무치악 환자에서 치매 발병률이 높다는 것을 확인할 수 있었다.