• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.473-485
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• 2023

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative-hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.49-57
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• 2023

Purpose : This study aimed to systematically review the correlation between hand dexterity and cognitive function in the elderly, and summarize various evaluation tests and results analysis methods for manual dexterity tests applied to this population. Methods : We searched published studies in the Korean Studies Information Service System and PubMed databases from January 2013 to March 2023. The main keywords used were "dexterity," "fine motor," "elderly," "cognitive function," and "correlation." A total of 10 studies were selected for analysis from the 1,524 searched articles. The included studies consisted of a cohort study, a longitudinal study, and eight cross-sectional studies which were analyzed for patients, intervention, comparison, and outcomes. Results : Analyzing the qualitative level of 10 studies, 8 articles (80%) were non-randomized two-group studies that provided level II evidence whereas the remaining 2 studies (20%) were non-randomized single-group studies (level III evidence). Therefore, these results indicated that the level of evidence in this field is generally high. The Purdue pegboard test was the most commonly used evaluation test for manual dexterity, and velocity speed was the most frequently employed analysis method. Results indicated that there were significant differences in manual dexterity test between the normal elderly, those with mild cognitive impairment, or dementia. Conclusions : These results can be used as a basis for selecting dexterity test evaluation items and methods to analyze it in the elderly while screening for cognitive impairment. In addition, this study highlights potential areas for future research on the development of manual dexterity evaluation tools and techniques for analysis and the need for more reliable and valid methods for assessing cognitive function in the elderly.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.28-33
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• 2014

Objective : Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. Methods : Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. Results : Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were $19.1{\pm}5.4$, $0.9{\pm}0.6$, and $3.3{\pm}1.1$. These were significantly lower than those of Group B ($25.6{\pm}3.4$, $0.5{\pm}0.2$, and $2.1{\pm}0.7$) (p<0.05). BIS was lower in Group A ($30.2{\pm}6.8$ compared to $35.4{\pm}5.6$ in group B) (p<0.05). The number of BIS <40 were $5.1{\pm}3.1$ times in Group A, $2.5{\pm}2.2$ times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. Conclusion : Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.140-146
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• 2013

Objectives: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. Methods: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. Results: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. Conclusions: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.

• 한국노년학
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• v.25 no.2
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• pp.127-141
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• 2005

Prior studies about nursing home placement identified factors contributing to the risk of institutionalization by pooling adult child caregivers and spousal caregivers together, regardless of differential challenges for the two types of caregivers. In a sample of 456 caregivers followed for a 2 year period, an event history analysis showed that relationship made difference in time to placement and that differential factors led to institutionalization for spousal caregivers and daughter caregivers. Spousal caregivers are more likely to place dementia patients into nursing homes sooner than adult child caregivers. The age of care recipients and role captivity (refers to being unwilling, involuntary incumbent of a caregiver role) are predictors of placement for both groups of caregivers. Dementia patients who were older had a greater risk of institutionalization. Greater feelings of role captivity also shortened the time to placement. Income and education are significant predictors only for caregiving daughters. Daughters who had a high education level are more likely to delay nursing home placement whereas those who had a higher income are more likely to institutionalize their demented parents sooner. Use of day care and behavioral problems are significant predictors only for spousal caregivers. Specifically, use of day care and behavioral problems precipitates nursing home placement. The findings of this study suggest that interventions for helping family members to provide care to the demented elderly at home must consider different circumstances faced by caregiving spouses and caregiving daughters.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.83-93
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• 2000

29 dementia patients over 60 years of no in the nursing home were assigned to execute rehabilitation program a month for 3 months. 1 evaluated MBI scores and MMSE scores and analyzed correlation between both scores. Analyses of results were as follows : 1. In the experimental group with rehabilitation program. ADL and cognitive function were improved significantly(p<0.05). 2. In the control group with no rehabilitation program. ADL was decreased significantly(p<0.05), cognition was not changed (pgt;0.05). 3. There were significant rises in MBI scores and MMSE scores in the experimental group(p<0.05). 4. There was a significant fall in MBI scores in the control group(p<0.05). a no change in MMSE scores in the control group(p>0.05). 5. There was strong correlation between ADL and cognition in the experimental group and the control group. 6. Inverse correlation revealed between the experimental group and the control group in ADL. 7. Inverse correlation revealed between the experimental group and the control group in cognition.

• 한국노년학
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• v.40 no.2
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• pp.325-340
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• 2020

Early diagnosis and intervention of dementia is critical to minimize future risk and cost for patients and their families. The purpose of this study was to develop and validate Figure-Copy Test(FCT), as a new dementia screening test, that can measure neurological damage and cognitive impairment, and then to examine whether the grading precesses for screening can be automated through machine learning procedure by using FCT imag es. For this end, FCT, Korean version of MMSE for Dementia Screening (MMSE-DS) and Clock Drawing Test were administrated to a total of 270 participants from normal and damaged elderly groups. Results demonstrated that FCT scores showed high internal constancy and significant correlation coefficients with the other two test scores. Discriminant analyses showed that the accuracy of classification for the normal and damag ed g roups using FCT were 90.8% and 77.1%, respectively, and these were relatively higher than the other two tests. Importantly, we identified that the participants whose MMSE-DS scores were higher than the cutoff but showed lower scores in FCT were successfully screened out through clinical diagnosis. Finally, machine learning using the FCT image data showed an accuracy of 73.70%. In conclusion, our results suggest that FCT, a newly developed drawing test, can be easily implemented for efficient dementia screening.

• Journal of the Korea Society of Computer and Information
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• v.28 no.11
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• pp.53-63
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• 2023

This study developed a cognitive impairment predictive model as one of the screening tests for preventing dementia in the elderly by using Automated Machine Learning(AutoML). We used 'Wearable lifelog data for high-risk dementia patients' of National Information Society Agency, then conducted using PyCaret 3.0.0 in the Google Colaboratory environment. This study analysis steps are as follows; first, selecting five models demonstrating excellent classification performance for the model development and lifelog data analysis. Next, using ensemble learning to integrate these models and assess their performance. It was found that Voting Classifier, Gradient Boosting Classifier, Extreme Gradient Boosting, Light Gradient Boosting Machine, Extra Trees Classifier, and Random Forest Classifier model showed high predictive performance in that order. This study findings, furthermore, emphasized on the the crucial importance of 'Average respiration per minute during sleep' and 'Average heart rate per minute during sleep' as the most critical feature variables for accurate predictions. Finally, these study results suggest that consideration of the possibility of using machine learning and lifelog as a means to more effectively manage and prevent cognitive impairment in the elderly.

• Tuberculosis and Respiratory Diseases
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• v.85 no.4
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• pp.349-357
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• 2022

Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.

• The Korean Journal of Applied Statistics
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• v.36 no.1
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• pp.33-48
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• 2023

In this paper we consider automatic speech recognition (ASR) for Korean speech data in which elderly persons randomly speak a sequence of words such as animals and vegetables for one minute. Most of the speakers are over 60 years old and some of them are dementia patients. The goal is to compare deep-learning based ASR models for such data and to find models with good performance. ASR is a technology that can recognize spoken words and convert them into written text by computers. Recently, many deep-learning models with good performance have been developed for ASR. Training data for such models are mostly composed of the form of sentences. Furthermore, the speakers in the data should be able to pronounce accurately in most cases. However, in our data, most of the speakers are over the age of 60 and often have incorrect pronunciation. Also, it is Korean speech data in which speakers randomly say series of words, not sentences, for one minute. Therefore, pre-trained models based on typical training data may not be suitable for our data, and hence we train deep-learning based ASR models from scratch using our data. We also apply some data augmentation methods due to small data size.