• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.461-469
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• 2021

Background: The global population is aging rapidly, and accordingly, the number of patients with dementia is increasing every year. Although the need for dental treatment increases for various reasons in patients with dementia, they cannot cooperate during dental treatment. Therefore, behavioral management, including sedation (SED) or general anesthesia (GA), is required for patients with dementia. Thus, this study aimed to investigate the trends and effects of SED or GA in patients with dementia undergoing dental treatment in South Korea based on the Korean National Health Insurance claims data. Methods: This study utilized customized health information data provided by the Health Insurance Review and Assessment Service. Among patients with records of using sedative drugs during dental treatment from January 2007 to September 2019, patients with the International Classification of Diseases-10 code for dementia (F00, F01, F02, F03, and G30) were selected. We then analyzed the full insurance claims data for dental care. Age, sex, sedative use, and dental treatment of patients were analyzed yearly. In addition, the number of cases of GA or SED per year was analyzed, and changes in behavioral management methods with increasing age were investigated. Results: Between January 2007 and September 2019, a total of 4,383 (male, 1,454; female, 2,929) patients with dementia received dental treatment under SED or GA. The total number of SED and GA cases were 1,515 (male, 528 ; female, 987 ) and 3,396 (male, 1,119 ; female, 2,277) cases, respectively. The total number of cases of dental treatment for 4,383 patients with dementia was 153,051 cases, of which 2.22% were under GA and 0.98% were under SED. Midazolam was the most commonly used drug for SED. Conclusion: Although gingivitis and pulpitis were the most common reasons for patients with dementia to visit the dentist, GA or SED for patients with dementia was frequently used in oral and maxillofacial or periodontal surgery.

• 한국치위생학회지
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• 제19권4호
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• pp.601-614
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• 2019

Objectives: The purpose of this study was to investigate the present conditions and problems of oral health care in senior citizens with dementia using a qualitative research method, through focused group interviews. Methods: Data was collected for approximately one month from May 2019. The subjects were divided into two groups: care workers and family caregivers. Fifteen participants were included in the study. Results: In-depth interviews with the care workers revealed the following three categories: characteristics of senile dementia patients, oral health care in senile dementia patients, and oral health care education. In-depth interviews with the family caregivers revealed the following four categories: characteristics of senile dementia patients, oral health care in senile dementia patients, oral health care education, and burden of care. The central themes common to both the care workers and family caregivers were the challenges owing to the characteristics of senile dementia patients, poor health condition of the senile dementia patients, difficulty in oral health care of the senile dementia patients, the desire to receive oral health care education and related information, and to access the information more easily. Additional central themes specific to the care workers were, the applicability of the intervention programs, variability between the facilities, and the problems of oral health care education. An additional central theme specific to the family caregivers was the burden of care. Conclusions: It is necessary to provide oral health care education and information to care workers and family caregivers of senile dementia patients, and to manage and support the dental health professionals ready to care for senile dementia patients. In addition, support to the family caregivers should not be limited only to the financial aspects, but also consider the psychological and emotional difficulties.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.40-47
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• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• 대한청각학회지
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• 제24권1호
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• pp.40-47
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• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• 한국임상약학회지
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• 제27권3호
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• pp.136-142
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• 2017

Background: Dementia is one of important social and economic healthcare issues in the aging age. Therefore, it signifies to analyze the relationship between chronic disease or cardiovascular drug use and the incidence of dementia to establish a basis for increasing or preventing the risk of dementia. The purpose of this study was to investigate the correlation between the prevalence of chronic diseases and the use of cardiovascular drugs in patients diagnosed with dementia. Methods: In this study, we used data from sample of elderly patients from the Health Insurance Review and Assessment Service. We analyzed by logistic regression analysis with age, gender, and medication as covariates. KCD-7 was used to diagnosis of the disease, and drugs were analyzed using ATC codes and Korean standardized drug classification codes. Results: A total of 1,276,331 patients were analyzed in the sample of the elderly population, of which 532,075 (41.7%) were male and 744,256 (58.3%) were female. The patients have the higher risk of dementia in the older, women, and lower socioeconomically status. Cerebral infarction and ischemic heart disease increases risk of dementia. Patients taking statins, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonists (ARB) showed low incidence of dementia. Conclusion: This study has been shown that ACEI, ARB, and statin drugs may associate with lower incidence of Alzheimer's and other dementia except vascular dementia.

• 한국치위생학회지
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• 제15권2호
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• pp.217-223
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• 2015

Objectives: The purpose of this study is to investigate cognitive function, performance of activities of daily living, and recognition on oral health with the cognitive function testto dementia or dementia-suspected patients in the outpatients. Methods: The subjects were 94 dementia or dementia-suspected patients visiting C University hospital for the dementia test. Study instruments included Korea Mini-Mental State Examination KMMS, The Bayer-Activities of Daily Living Scale; B-ADL, Seoul-Instrumental Activities of Daily Living; S-IADL, Global Deterioration Scale; GDS, Korean Dementia Screening Questionnaire; KDSQ, and underlying diseases. Results: Dementia or dementia-suspected patients were 42 by KMMSE test, 25 patients had impaired functioning of daily living by B-ADL test, 27 patients showed the presence of depression by GDS test, and 45 patients showed impaired functioning of daily living. There was a statistically significant difference in the subjective recognition on oral health conditions. There was a statistically significant difference in the subjective recognition on oral health conditions by ADL. There was a positive correlation between the cognitive function and ADL performance. Higher cognitive function is proportional to ADL performance. Conclusions: The cognitive function was closely associated with ADL and subjective oral health conditions.

• 복식
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• 제56권6호
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• pp.45-57
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• 2006

The purpose of this research was to find the present condition on dementia patients clothes design including shapes, colors, construction and details in domestic. This research was for confirming the present problems, suggestions, and basic informations for development dementia patients clothes proto-types. The research methods and process were as follows; 1. The total 20 institutes (5 dementia specialty hospitals, 3 the senior hospitals and 11 nursing care centers) were researched during from June to August, 2005 by trained researchers who had experiences researches. 2. The total 30 nurses and care-givers were interviewed for find the present problems related the dementia patients clothes. 3. The total 39 suits for dementia patients clothes were collected and the design analysed such like shapes, colors, constructions and details by taking pictures and drawing flat works. 4. The present condition about the clothes and problems were found and suggest new ideas. The results were belows; 1 The most of institutes of domestic area had two piece type like general hospital patients' clothes for dementia patients clothes. It means there are no concerning now for old dementia patients. 2. The white colors were firstly used as fabric ground and secondly pale tone or pastel tone colors were used The blue and pink were used as pattern colors. The pattern colors were usually moderate tones. 3. The characteristics of constructions and details were round neckline, buttons, full-length sleeves, straight pants, ankle length pants. 4. New functional fabrics and designs for emotional satisfaction were demanded for dementia patients.

• 대한치과의사협회지
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• 제56권4호
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• pp.231-237
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• 2018

The number of patients with dementia in Korea is estimated to be 576,000 in 2013 and 648,000 in 2015, and 840,000 in 2020 and 2,710,000 in 2050. Therefore, it can be expected that the number of patients with dementia will increase among the elderly patients who are looking for dentistry. Dementia and oral hygiene are closely related, so the future role of the dentist is very important. In order to treat effectively the patients with cognitive disorders, we should consider effective communication methods with them. Xerostomia is another important factor affecting oral health of dementia patients. In establishing the dental treatment plan, the most appropriate treatment method should be selected considering the characteristics of individual dementia patients and all possible efforts should be made for successful treatment results.

• 한국임상약학회지
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• 제30권2호
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• pp.81-86
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• 2020

Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

• 한국응용과학기술학회지
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• 제36권4호
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• pp.1373-1384
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• 2019

본 연구는 지역사회 내 치매환자가족의 돌봄부담감에 미치는 영향요인을 분석하기 위한 서술적 조사연구이다. 자료수집은 2018년도 11월 30일~12월 9일까지 10일간 지역사회 내 치매환자가족 223명을 대상으로 하였다. 연구의 결과 인구사회학적 특성에 따른 돌봄부담감 정도는 치매환자가족의 주돌봄자 연령대, 치매환자와의 관계, 치매환자 돌봄기간, 치매환자 돌봄 시 어려운 점에 따라 통계적으로 유의한 차이가 있었으며 돌봄부담감은 치매지식과 부적상관관계(r=-.145, p=.030)가 있었다. 치매환자가족의 돌봄부담감에 미치는 영향요인으로는 치매환자 돌봄기간(β=.408, p=.006), 치매환자 돌봄시 어려운 점(β=-.307, p=.023), 치매환자와의 관계(β=-.299, p=.013), 치매환자가족의 주돌봄자 연령대(β=-.265, p=.007) 순으로 영향을 미치고 있음이 확인되었다. 이에 지역사회 내 치매환자가족의 돌봄부담감 완화를 위한 실질적이고 지속적인 돌봄중재 프로그램이 필요하며 특히 치매환자 가족돌봄자를 대상으로 체계적이고 주기적인 신체적·정신적 건강관리가 필요하다.