• Title/Summary/Keyword: Elderly Dementia Patients

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Assessment of Gait as a Diagnostic Tool for Patients with Dementia (치매 진단도구로서 치매노인의 보행능력 평가에 대한 연구)

  • Lee, Han-Suk;Park, Sun-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.129-136
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    • 2017
  • PURPOSE: The purpose of this study was to compare the gait of elderly patients with and without dementia to investigate the possibility of an ambulation assessment test as a diagnostic tool for dementia. METHODS: A total of 96 subjects were included with 60 participants without dementia (control group) and 36 patients with dementia (dementia group). To compare the walking ability of the two groups, a 4-m walking test (4MWT) and Groningen Meander Walking Test (GMWT) were conducted. The GMWT is graded by amount of time in seconds and by number of oversteps outside the track. Mann-Whitney U test was used to compare the gait between the groups and the area under the curve (AUC) with Received Operating Characteristic (ROC) curve was analyzed. Statistical significance was considered at a p<.05, with a 95% confidence interval. RESULTS: There were statistically significant differences (p<.05) between the dementia group and the control group for the 4MWT, GMWTSEC, and GMWTSTEP scores. The AUC was .95 for 4MWT, .92 for GMWTSEC, and .96 for GMWTSTEP with the 95% confidence interval. The cut-off values of the ROC curve were 1.03m/s for 4MWT, 10.8 second for GMWTSEC, and 3.75 steps for GMSTEP. CONCLUSION: In our study, we investigated the utility of ambulatory assessment tools to predict dementia. The results of this study suggest that the 4MWT and the GMWT used in this study are appropriate assessment tools for dementia prediction.

Health-Related Quality of Life among Women Caregivers of Older Adults with Dementia (치매노인을 부양하는 여성의 건강관련 삶의 질)

  • Kim, Myoung Soo;Kim, Dong-Hee;Kim, Jung Soon;Park, Kyung Yeon;Park, Nam Hee
    • Korean Journal of Adult Nursing
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    • v.19 no.1
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    • pp.24-34
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    • 2007
  • Purpose: The objective of this study was to define the predictors of health related quality of life(HRQoL) of women caregivers of the demented elderly patients. Methods: The subjects of this study were 140 pairs of patients with dementia and their caregivers. The characteristics of dementia patients and caregivers, Barthel index and SF-36 were measured in this study. T-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. Results: The health related quality of life(HRQoL) score of women caregivers was $288.35{\pm}66.10$ for norm based scoring. HRQoL of women caregivers was correlated with patients' ADL, severity of dementia, caregivers' age, burden, and family support. The major factors that affected the physical components of women caregivers of patients with dementia was the age of the caregiver, burden, and ADL which explained 36.0% of HRQoL. The main predictors of women caregivers' emotional state was the caregiver's burden. Conclusion: Patients' support systems must be implemented to improve the physical HRQoL of caregivers. A caregivers' burden relief program needs to be prepared to increase their emotional HRQoL and further studies and efforts will be needed to evaluate those effects.

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A Study on the Design Guidance for Remodeling Small and Medium Hospitals into Nursing Homes in Korea (국내 중.소규모 병원을 노인 요양시설로의 리모델링시 요구되는 디자인 지침에 관한 연구)

  • Park, Hyunjun;Choi, Sanghun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.16 no.2
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    • pp.17-28
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    • 2010
  • The considerable increase of the elderly with dementia is expected annually and when we think about the family members' and the patients' suffering, it could be painful. Above all things, it imposes heavy economic burdens on the family members that have patients who suffer from diseases of age like dementia or paralysis that caring them at home and also, it is not desirable for those old people in point of physical or environmental circumstances for medical care. Thus, it is needed urgently that the expansion of specified facilities and improvement of services for these old people. Under this present condition, it is the special feature that the subject of research is people/facilities that offer services, not the elderly with dementia-the main user of those facilities. This proposal aims to make a study of expansion and improvement the old people's welfare facilities by using remodeled closed Small and Midium Hospitals which are the bad effect of economic growth. Also, it can save money with re-using abolished buildings which is property of the nation and protect environment too. In this study, We examine the present conditions of old people's welfare institution, and research a factor of remodeling for welfare facilities. Then we will verify remodeling-possibility which is concrete and working by using the product of this study.

The Reliability of Balance, Gait, and Muscle Strength Test for the Elderly with Dementia: A Systematic Review

  • Lee, Han-Suk;Park, Sun-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.3
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    • pp.49-58
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    • 2017
  • PURPOSE: To summarize the evaluation tools of balance [Berg Balance Scale (BBS), timed up and Go (TUG), forward reaching test (FRT)], gait [6 m walking Test (6MWT)], and strength [Chair Stand Test (CST)] for patients with dementia. METHODS: The following databases were searched: Pub MED, Cochrane, Sciences Direct, and Web of Sciences. The inclusion criteria were as follows: 1) repeated measurement design, 2) subjects with dementia, 3) use of testing tools such as the BBS, TUG, FRT, 6MWT, and CST, 4) report the reliability. One reviewer performed the quality assessment of diagnostic accuracy study and two evaluators performed data extraction independently. RESULTS: Six articles and one letter were included. The interrater reliability of 6MWT, TUG, and CST, were acceptable (ICC>.90). However, FRT had unacceptable reliability. In test-retest reliability, only BBS has acceptable reliability (ICC>.90). Others had various reliabilities. The risk of interrater reliability bias was low in all studies. However, the risk of bias of intrarater reliability was low in five studies and moderate in two studies. CONCLUSION: The interrater reliability of the 6MWT, TUG, and CST were acceptable. However, in test-retest reliability, only BBS has acceptable reliability. Therefore, we suggest the use of BBS to test the balance of dementia patients. In addition, the study of tool reliability according to the subtype of dementia is needed in the future.

Deep Learning-based Abnormal Behavior Detection System for Dementia Patients (치매 환자를 위한 딥러닝 기반 이상 행동 탐지 시스템)

  • Kim, Kookjin;Lee, Seungjin;Kim, Sungjoong;Kim, Jaegeun;Shin, Dongil;shin, Dong-kyoo
    • Journal of Internet Computing and Services
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    • v.21 no.3
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    • pp.133-144
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    • 2020
  • The number of elderly people with dementia is increasing as fast as the proportion of older people due to aging, which creates a social and economic burden. In particular, dementia care costs, including indirect costs such as increased care costs due to lost caregiver hours and caregivers, have grown exponentially over the years. In order to reduce these costs, it is urgent to introduce a management system to care for dementia patients. Therefore, this study proposes a sensor-based abnormal behavior detection system to manage dementia patients who live alone or in an environment where they cannot always take care of dementia patients. Existing studies were merely evaluating behavior or evaluating normal behavior, and there were studies that perceived behavior by processing images, not data from sensors. In this study, we recognized the limitation of real data collection and used both the auto-encoder, the unsupervised learning model, and the LSTM, the supervised learning model. Autoencoder, an unsupervised learning model, trained normal behavioral data to learn patterns for normal behavior, and LSTM further refined classification by learning behaviors that could be perceived by sensors. The test results show that each model has about 96% and 98% accuracy and is designed to pass the LSTM model when the autoencoder outlier has more than 3%. The system is expected to effectively manage the elderly and dementia patients who live alone and reduce the cost of caring.

The Correlation between Problematic Behaviors and Activities of Daily Living of Elderly People with Dementia in Patients in a Geriatric Hospital

  • Wang, Joong San;Lee, Ju Hwan;Um, Ki Mai
    • Journal of International Academy of Physical Therapy Research
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    • v.4 no.2
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    • pp.545-551
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    • 2013
  • The purpose of this study is to determine the correlations between problematic behaviors and activities of daily living(ADL) targeting 106 demented elderly people hospitalized in a geriatric hospital. To examine the cognitive function of the subjects, the study used Korean Mini Mental State Examination(K-MMSE). For problematic behaviors and ADL, the study collected data based on Patient Assessment Forms in the geriatric hospital. Among problematic behaviors, apathy/indifference had the highest correlation with the items of ADL. Irritability/lability, agitation/aggression, depression/ dysphoria, night-time behavior and wandering also showed to be correlated to items of ADL(p<.05). This study demonstrated that cognitive function, problematic behaviors and ADL of the demented elderly hospitalized in the geriatric hospital are correlated to each other.

Status of Protection Management and Countermeasures of Caregivers and Managers for Problem Behaviors of the Elderly with Dementia - Focused on Uiseong Nursing hospitals (치매노인의 문제행동에 대한 간병인과 관리자의 보호관리 실태와 대책 - 의성지역 요양병원을 중심으로)

  • Kang, Sung-Kwan;Park, Jeong-Kyu
    • The Journal of the Korea Contents Association
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    • v.22 no.2
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    • pp.752-761
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    • 2022
  • The purpose of this study is to present basic data for developing patient-centered care by identifying the current situation and problems of caregivers' protection management for the problem behaviors of the elderly with dementia targeting caregivers working at three nursing hospitals among the facilities for the elderly in the Uiseong area. From January 2021 to July 2021, 1 caregiver with less than 1 year, 5 caregivers with 1 to 3 years of care, and 2 caregivers with 4 years or more, who are directly caring for the elderly with dementia in clinical practice working at a nursing hospital, managing and supervising them A total of 13 patients were included, including 3 nurses and 2 secretary generals. As a qualitative case study, the results of caregivers' protective management for the problem behaviors of the elderly with dementia were listed in mental, physical, and relational aspects. Conflicts in the process and the results of conflicts in the care process with hospital managers are listed based on case studies. More specifically, the efforts and passion of researchers to understand the problem behaviors of the elderly with dementia and to devise and verify practical management methods based on this are urgently needed. It will be necessary to secure data of various case studies in clinical practice through research methods.

A Taxonomy of Geriatric Hospitals Using National Health Insurance Claim Data (건강보험청구자료로 본 요양병원의 기능 유형)

  • Min Kyoung Lim;Sun-Jea Kim;Jeong-Yeon Seon
    • Korea Journal of Hospital Management
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    • v.28 no.2
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    • pp.9-20
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    • 2023
  • Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

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Preliminary Study to Develop the Korean Medical Pathologic Aging Scale and Korean Medical Pattern Identification for Dementia (한의학 병리적 노화 척도와 치매 한의학적 변증진단 개발 및 신뢰도 평가)

  • Lee, Go eun;Moon, Kwang Su;Kim, Nam Kwen;Chung, sun yong;Jung, In Chul;Kang, Hyung Won
    • The Journal of Korean Medicine
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    • v.38 no.3
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    • pp.111-123
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    • 2017
  • Objectives: To develop and investigate the reliability of the pathologic aging scale based on korean medical theory and korean medical pattern identification for dementia. Methods: We searched the textbook of korean neurophychiatry and Donguibogam and selected items through professional consensus. We compared between dementia(n=40) and normal elderly(n=38) and tested the reliability of two scales. Results: After professional consensus, we drafted the Korean Medical Pathologic Aging Scale(12 items, Likert 3 scale) and Korean Medical Pattern Identification for Dementia(4 patterns, 28 items, Likert 5 scale). On Korean Medical Pathologic Aging Scale, There is no significant difference between two groups. We had good internal consistency(Cronbach's alpha = 0.6) and test-retest reliability(r=0.631) but low inter-rater reliability(r=0.430). On Korean Medical Pattern Identification for Dementia, dementia patients diagnosed with Qi deficiency are significantly more than those in normal group. We had fairly good internal consistency(Cronbach's alpha = 0.574) and excellent test-retest(kappa= .800) and inter-rater reliability(kappa = .733). Conclusions: Korean Medical Pattern Identification for Dementia is appropriate for diagnosing korean medical pattern. But Korean Medical Pathologic Aging Scale isn't appropriate to discriminate dementia from normal elderly because of many subjective items. Therefore objective measurement of sensory dysfunction would be needed to measure pathologic aging based on korean medical theory.

Analysis of domestic dementia research trend for integrated study (융복합 연구를 위한 국내 치매 관련 연구동향 분석)

  • Yoo, Soonduck;Baik, Meera
    • Journal of Convergence for Information Technology
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    • v.7 no.3
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    • pp.1-12
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    • 2017
  • The purpose of this study is to contribute to research on dementia and policy making by reviewing research trends of dementia for 15 years and it was collected from 12,588 dementia - related research data for 15 years at Google 's scalar site. The results of this study confirm that the research on dementia, one of the most common geriatric diseases, is continuously increasing. Second, research on dementia is increasing due to social influences such as government support. Third, we suggested that dementia is changing from a viewpoint of diseases to be managed at the facility and treatment of severe dementia patients to a paradigm from the viewpoint of management of mild patients and community participation. Fourth, dementia seems to be shifting from a serious and negative awareness to a social atmosphere that is accepted as a slow but manageable disease. This is changing to a dementia-friendly social environment, which is making a very positive environmental change. This study contributes to the field research by presenting the trend of domestic research on dementia.