• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.74-83
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• 1997

With increasing tendency of incidence and interest for the late onset schzophrenia, concerns about whether this disorder is etiologically or phenomenogically distinctive entity or not have increased also. To clarify the disease entity of the late onset schzophrenia and the role of structural brain changes in its etiology, authors tried to prove following hypothesis : Are there any evidences of structural brain changes in the lateonset schizophrenia? ; If present, are they not different from those of the early-onset schizophrenia or progressive schizophrenia? ; And are they not different from those of senile dementia? Subjects were 6 patients with the late-onset schizophrenia, 6 patients with the early-onset schizophrenia, 6 patients with progressive schizophrenia, 6 patients with Alzheimer's dementia, and 6 controls. We measured regions of interest of the magnetic resonance images by computer assisted planimetry using the AutoCad and digitizer. Our study results may suggest that the third ventricular enlargement and a reversal of normal difference between left and right temporal lobe and left-right difference in posterior lateral ventricle are common brain pathology for all types of schizophrenia including the late onset schzophrenia. And also suggest that brain structural changes of the late onset schizophrenia are related with neurodevelopmental abnormality rather than degenerative change.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.3926-3933
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• 2015

The purpose of this study was to determine the factors associated with duration of postoperative delirium following orthopedic joint surgery. This study included 266 patients who underwent orthopedic joint surgery at a single university hospital between January 2012 and February 2014. Patients were divided into two groups according to the duration of delirium: the transient (${\leq}2$ days) and prolonged (>3 days) delirium groups. Of the 266 patients, 137 (52%) developed prolonged delirium. Incidence of pre-existing dementia and history of stroke were significantly higher in the prolonged delirium group than in the transient delirium group. In a multivariate regression model, pre-existing dementia and history of stroke were associated with increased duration of delirium. Our findings suggest that medical practitioners should pay special attention to the prevention and management of postoperative delirium in patients who have dementia or stroke and undergo orthopedic joint surgery.

• Journal of Korean Neurosurgical Society
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• v.43 no.3
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• pp.143-148
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• 2008

Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

• The Journal of Korean Medicine
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• v.29 no.5
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• pp.67-76
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• 2008

Objectives : Amnesia is theloss or impairment of memory, caused by physical injury, disease, drugs, or emotional trauma. Recently, the average life span is increasing, while at the same time, the incidence of dementia-like diseases in conjunction with amnesia are also increasing. Therefore learning and memory are very important issues in modern society. Ancient Korean physicians used several herbs to treat dementia and these herbal effects were described in Korean herbal books. Among them are some reports on several cognitive-enhancing herbs which have since been shown to improve dementia in recent pharmacological studies, such as Panax ginseng; however, the facilitatory effects of many Korean cognitive-enhancing herbs on learning and memory are limited. Learning and memory are essential requirements for every living organism in order to cope with environmental demands; cholinergic systems are known to be involved in learning and memory. Methods : In this study, the effects of Acori graminei rhizoma (AGR, 石菖蒲) on learning and memory were investigated by Morris water maze, eight-arm radial maze, and the effects on the central cholinergic system of rats injected with scopolamine. Results : In the water maze, the experimental animals were trained to find a platform in a fixed position for 6 days and then received a 60 sec probe trial in which the platform was removed from the pool on the 7th day. In the eight-arm radial maze, the animals were tested four times per day for 6 days. Scopolamine impaired performance of the maze tests and reduced activity of acetylcholinesterase (AchE) in the hippocampus, which is a marker for the central cholinergic system. There were significant reversals from the scopolamine-induced deficits on learning and memory in these tests, through daily administrations of AGR (100 mg/kg, p.o.) over 14 consecutive days. These treatments also reduced the loss of cholinergic activity in the hippocampus induced by scopolamine. Conclusions : These results demonstrated that AGR ameliorated learning and memory deficits by affecting the central acetylcholine system.

• Dementia and Neurocognitive Disorders
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• v.17 no.4
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• pp.156-162
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• 2018

Background and Purpose: Previous studies have reported conflicting results about the prevalence of seizures in Alzheimer's disease (AD). There are few epidemiological studies on this topic in Asia. Thus, the objective of this study was to examine demographic and clinical characteristics as well as incidence for seizures in AD patients compared to non-AD patients in a prospective, longitudinal, community-based cohort with a long follow-up. Methods: Data were collected from National Health Insurance Service-National Elderly Cohort (NHIS-elderly) Database to define patients with AD from 2004-2006 using Korean Classification Diseases codes G30 and F00. We performed a 1:5 case-control propensity score matching based on age, sex, and household income. We conducted Cox proportional hazards regression analysis to estimate the risk of epilepsy in AD patients. Results: In the cohort study, patients with AD had higher risk for epilepsy than those without AD, with hazard ratio of 2.773 (95% confidence interval [CI], 2.515-3.057). This study also showed that male gender and comorbidities such as hypertension, hyperlipidemia, diabetes, and chronic kidney disease increased the risk of developing epilepsy. Patients with AD had 1.527 (95% CI, 1.375-1.695) times higher mortality rate than those in the control group. Conclusions: AD patients have significantly higher risk of developing epilepsy than non-AD patients.

• Journal of Convergence for Information Technology
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• v.9 no.8
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• pp.248-253
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• 2019

Early diagnosis of mild cognitive impairment (MCI) can reduce the incidence of dementia. This study developed the MCI prediction model for the elderly in Korea. The subjects of this study were 3,240 elderly (1,502 men, 1,738 women) aged 65 and over who participated in the Korean Longitudinal Survey of Aging (KLoSA) in 2012. Outcome variables were defined as MCI prevalence. Explanatory variables were age, marital status, education level, income level, smoking, drinking, regular exercise more than once a week, average participation time of social activities, subjective health, hypertension, diabetes Respectively. The prediction model was developed using Restricted Boltzmann Machine (RBM) neural network. As a result, age, sex, final education, subjective health, marital status, income level, smoking, drinking, regular exercise were significant predictors of MCI prediction model of rural elderly people in Korea using RBM neural network. Based on these results, it is required to develop a customized dementia prevention program considering the characteristics of high risk group of MCI.

• Nutrition Research and Practice
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• v.15 no.2
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• pp.173-186
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• 2021

BACKGROUD/OBJECTIVES: Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Due to the increased incidence of dementia, there is a corresponding increase concerning the importance of AD. In this study, we investigated the protective effects conferred by Zizyphus jujuba (Zj) and Zizyphus jujuba fermented by yeast (Zj-Y), on cognitive impairment in an AD mouse model. MATERIALS/METHODS: AD was induced by injecting amyloid beta25-35 (Aβ25-35) in ICR mice, and subsequently 200 mg/kg Zj or Zj-Y was administered daily for 14 days. The cognitive ability of AD mice was observed through behavioral experiments in T-maze, novel object recognition, and Morris water maze tests. We subsequently measured the levels of malondialdehyde (MDA), nitric oxide (NO), aspartate aminotransferase, and alanine aminotransferase in either tissues or serum. RESULTS: In behavioral tests, deterioration was revealed in the short- and long-term learning and memory functions in the Aβ25-35-injected control group compared to the normal group, indicating that Aβ25-35 injection impairs cognitive functions. However, administration of Zj and Zj-Y improved cognitive function in mice, as compared to the Aβ25-35-injected control mice. In addition, the Aβ25-35 induced elevations of MDA and NO in the brain, kidney, and liver were suppressed after exposure to Zj and Zj-Y. Especially, Zj-Y showed stronger scavenging effect against MDA and NO, as compared to Zj. CONCLUSIONS: Results of the present study indicate that Zj-Y exerts a protective effect on cognitive impairment and memory dysfunction, which is exerted by attenuating the oxidative stress induced by Aβ25-35.

• 한국노년학
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• v.32 no.4
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• pp.993-1011
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• 2012

The purpose of this study is to investigate the factors associated with the incidence and the transition of disability among Korean older adults. Samples consist of 1,454(42.7%) men and 2,032(58.3%) women aged 65 and over who participated in the 1st and 2nd wave of the Korea Longitudinal Study of Aging: KLOSA. To estimate the level of disability, ADL and IADL disability indexes are used. As the results, major risk factors for ADL/IADL disability incidence include injury, vision problem, cognitive function, depression, health behavior, socioeconomic characteristics and age. Among the normal older adults, the odds ratio of having dementia symptoms at 2nd wave(2008) are 2.0 times greater for the older adults who have less cognitive function than those who don't have at 1st wave(2006). Among the older adults with chronic diseases, the odds ratio of having disability at 2nd wave are 1.8 times greater for the older persons who have depression than those who don't have at 1st wave. Secondly, concerning the predictors affecting the disability transition among the disabled older adults at 1st wave, the likelihood of remaining at the same level or deteriorating the level of IADL disability, as compared with improving the level, is associated with having less instrumental support or being older. These results indicate that it is necessary to prefer multilevel intervention in order not only to prevent the incidence of disability, but also to prolong the deterioration of disability in the older adults.

• Journal of Korean Academy of Nursing
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• v.35 no.4
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• pp.745-753
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• 2005

Purpose. The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. Methods. One-group, time series, quasi-experimental design with a pre-test and two post- tests was used. Data were collected from cognitively impaired home residents (N = 32) and nursing staff (N = 36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. Results. Incidence of aggressive behavior was high with a mean score of 3.09 (SD = 3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F = 2.925, p = .066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.00l). Conclusion. Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.

• Health Policy and Management
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• v.28 no.4
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• pp.352-359
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• 2018

Background: The purpose of this study is to propose an analysis of trends and characteristics of high-cost patients who take over 40% of total national health insurance medical expenses. Methods: It has been analyzed the tendency of high-cost patients by open data based on the medical history information of 1 million people among national health insurance subscriber from 2002 to 2015. To conduct detailed study of characteristics of high-cost patients, multiple regression has been performed by sex, age, residence, main provider, and admission status based on the top 5% group. Results: The amount of medical expenses and the number of high-cost patients have gradually increased in decades. The number of high-cost patients for Korean won (KRW) 5,000,000 category has increased by 7.6 times, KRW 10,000,000 category has increased by 14.1 times in comparing of year 2002 and 2015. Top 5% medical expenses have increased by 4.6 times. In consideration of the characteristics of patients, the incidence of high medical expenses has been higher in female patients than male ones, the older patients than in the younger. Patients residence in Gyeonsang or Jeonla province have had a high incidence of medical expenses than other area. The disease including dementia, cerebral infarction, and cerebrovascular disease for high-cost patients has been also increased. Conclusion: The major increase factor for high medical expenses is the aging of population. The elderly population receiving inpatient care residing in the province that increases high medical costs have to management. There is an urgent need to develop a mechanism for predicting and managing the cost of high-cost medical expenses for patients who have a heavy financial burden.