• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.155-163
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• 2019

Objectives : The aim of this study was to compare severity, neurocognitive functions, and behavioral and psychological symptoms of dementia (BPSD) according to the degree of temporal lobe atrophy (MTA) in Korean patients with dementia due to Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease. Methods : Participants were 114 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. Severity was evaluated with Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Neurocognitive functions was evaluated with the Korean version of Short Blessed Test (SBT-K) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). BPSD was evaluated with the Korean version of the Neuropsychiatric Inventory (K-NPI). Independent t-test was performed to compare severity, neurocognitive functions, and BPSD between two groups. Results : The group with high severity of MTA showed significantly lower scores in CDR, SBT-K, MMSE-KC, modified Boston naming test, word list recognition, and word list memory (p<0.05). There were no differences in K-NPI scores between two groups. Conclusions : Severity and neurocognitive functions of dementia had significant positive association with MTA, but BPSD had no association with MTA. Evaluating MTA seems to have potential benefit in diagnosing and treating neurocognitive impairments in the elderly. Further evaluation is needed to confirm the association between certain brain structures and BPSD.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.11
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• pp.4234-4243
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• 2010

Dementia such as poor concentration, anxiety and tension makes it hard to continue exercise in reality. For this, intermediate exercise is suggested in this study. And the study investigates the effects on senior fitness, cognitive function(MMSE-K) and daily living activity(ADL) by continuous exercise and intermittent exercise, which helps to provide proper exercise treatment to them. For this, female elderly patients at A dementia hospital in B Metropolitan city are selected and they have been diagnosed with possible Alzheimer's disease according to DSM-IV. Among them, six(6) are grouped for continuous exercise and five(5) for intermediate exercise, total 11 people are finally tested. They are given hand&foot exercise, Korean folk dance and band exercise three times a week for the total 12 weeks. The continuous exercise group does their exercise one time of 30 minutes a day while the intermediate exercise group for three times of each 10 minute a day. For the result, SPSS Ver. 18.0 is used to get mean value(M) and standard deviation(SD) and in order to verify the interaction effect between exercise group and time, two-way repeated ANOVA is applied and statistical significance level is set at .05. The result shows that there is significant difference in time between senior fitness and cognitive function. But there is no significant difference in group and time${\times}$group. And there is no significant difference in time, group and time${\times}$group for daily living activity. Continuous exercise group and intermediate exercise group both have the similar effects. That does not mean that intermediate exercise is the best for all people with dementia, but in terms of exercise time, intermittent exercise may be effective for patients of light dementia.

• Journal of Korean Clinical Health Science
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• v.10 no.2
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• pp.1600-1606
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• 2022

Objective: This study was to compares and analyzes programs applied to improve cognitive function in patients with mild cognitive impairment and early dementia in the community to find out their effectiveness. Methods: In this study, 12 papers were finalized by searching for "elderly", "cognitive", "community", and "program" using the database of the Research Information System (RISS), National Assembly Library, and Korean Studies Information (KISS). Results: Programs for cognitive function were in the order of cognitive stimulation program, arts and crafts, and exercise program. In the program, rather than applying the cognitive stimulation program alone, the program was operated by combining leisure or exercise, music, art, and handicraft. The time was shown to be 30 minutes. The most frequently used evaluation tool was MMSE, followed by GDS and BBS. By cognitive domain, cognitive stimulation program and memory, satisfaction in psychology, and balance ability in exercise were evaluated the most. In the cognitive area, various cognitive stimulation areas were included, and in the exercise area, basic exercise, muscle strength exercise, joint exercise, and balance exercise were applied. Conclusion: Therefore, developing a program to improve cognitive function for mild cognitive impairment, it will be possible to prepare guidelines to establish and development.

• Journal of the Korean Dietetic Association
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• v.12 no.4
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• pp.313-328
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• 2006

This study was objectively performed to identify dietitians' job in the elderly health-care facilities, to assess facilities and dietitian's demographic characteristics, and to determine performance and importance of dietitian's job including the demand of therapeutic diet development. Survey was conducted by mail and samples were the dietitians working in 376 facilities which capacity is over 50 members from nationwide 583 the elderly health-care facilities. Returned questionnaire was 102 and used for statistic analysis. The distributions of the elderly health-care facilities showed 39 the elderly nursing facilities(38.2%), 32 skilled nursing facilities (32.4%), 13 geriatrics hospital facilities(12.7%) and 9 the elderly cost nursing facilities(8.8%). 60.0 percent of the samples showed its menu price as 1,000 to 1,500 won. A cycle-menu program was in-use at the 79.0% facilities, but only 7.1% facilities have been introduced a selected menu system. 92.9% facilities employed only one dietitian. In the demographic characteristics of dietitian only 14.7% dietitian had a clinical dietitian license and 51.5% of respondents answered at least 1 to 3 months internship program is needed. Job activities of the dietitian in the elderly health-care foodservice were identified as 45 activities with 9 dimensions. Job performance score evaluated dietitian oneself was 4.71 of 7 points. The average importance score that the dietitian evaluated their own job was 5.66 points of 7. The job activities shown higher importance but lower performance were therapeutic diet development for in-patients, menu development suitable for taste of the elderly, and leadership. Job performance score by characteristics of dietitian and their elderly health-care facilities was significantly associated with experience of dietitian in elderly health-care (F=4.480, p<0.05), education of dietitian(F=2.659, p<0.01), number of dietitian(F=2.245, p<0.05), and number of employee in foodservice(F=2.607, p<0.05). Most common diseases of the aged was proved as hypertension(81.7%), diabetes mellitus(71.4%), and dementia(65.0%). The therapeutic diets frequently provided were diabetes mellitus diet, dysphagia diet, low sodium diet, high fiber diet, and high protein diet, in order. For those reasons, dietitian in the elderly health care emphasized that the information about therapeutic diet development such as diabetes mellitus diet, dysphagia diet, low sodium diet and hypertension diet must be continuously developed and provided. The result from this study can be applicable to enlarge and enrich job activities of dietitian in elderly health-care foodservice.

• 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.

• Journal of The Korea Institute of Healthcare Architecture
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• v.7 no.2
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• pp.59-69
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• 2001

The purpose of this study is to provide a basic data for architectural planning on the wards and special quality of physical remedy spaces of geriatrics hospital. This research, to analyse dependency degree of inpatients in geriatric hospital, shows relativeness between remedy space and wards, and to show behavior of each patients reaction to there space. Result of interviewed inpatients who were sorted by age, sex, dependency degree, and days in hospital, suitable space programming is to need for physical and mental state. On the bases of survey and analysis, the basic data for planning and design the hospital for the elderly with dementia has been proposed.

• Therapeutic Science for Rehabilitation
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• v.3 no.1
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• pp.31-37
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• 2014

Objective : The purpose of this study was to look at a systematic review on the effects of occupational reminiscence therapy in Dementia offered National Long term care Insurance. Through this comprehensive study, we have to compare the studies. Methods : We systematically examined papers published in journal from 2009 to 2013, using KERIS. Main words to examine are Dementia, Long term care service, Day care center, reminiscence therapy, occupational centered, etc. Results : 6 studies were selected, All of them were occupational reminiscence therapy. Reminiscence therapy can be devided into communication centered reminiscence therapy and occupational reminiscence therapy. The results demonstrated that the intervention significantly affected the maintenance cognitive skills and reminiscence skills, decreased depression, behavioral changes, improvement of communication and interaction skills and quality of life etc. of elderly people with dementia (p<.05). Conclusions : If occupational therapists can obtain knowledge and make a program for occupational reminiscence therapy, research in this field will be further developed. In the future study, the use of occupational reminiscence therapy applied to a variety of interventions and majority of patients is needed on occupational therapy.

• 한국노년학
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• v.37 no.3
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• pp.747-762
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• 2017

Recently, as the number of patients with dementia using nursing homes increases, the interest about the quality of care services is increasing. Job satisfaction of caregivers is very important factor in the quality of care service. In addition, as perception of human rights is heightened, human rights behavior in nursing homes is also recognized as an important factor. The purpose of this study is to investigate the structural relationship between job satisfaction and human rights behavior, job stress, and social support of dementia workers who have significant influence on quality of care service. For this purpose, 210 questionnaires were collected from 300 dementia workers working in the elderly nursing home, day night care center, and domiciliary visit care center in Gyeonggi province. After excluding 13 questionnaires, the questionnaires were analysed by AMOS and SPSS 21.0. The results of the analysis are following. It was found that job stress significantly affects the social support directly (-.276). Also, social support significantly affects job satisfaction (.315). On the other hand, human rights advocacy has a direct effect on job satisfaction (.175) and an indirect effect (.102), showed a total effect of (.277). This shows that social support partially mediates human rights advocacy and job satisfaction. Job stress had a direct effect on job satisfaction(-.217) and an indirect effect(-.095), indicating a total effect of (-.312), and social support partially mediated job stress and job satisfaction Could know. The results of this study suggest that in order to improve the job satisfaction of the dementia workers, it is necessary to increase the human rights advocacy behavior and reduce the job stress in an environment that recognizes the social support.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.354-377
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• 2002

Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.123-129
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• 2022

Objective : Chronic subdural hematoma (CSDH) is one of the most common pathology in daily neurosurgical practice and incidence increases with age. The aim of this study was to evaluate the prognostic factors and surgical outcome of CSDH in patients aging over 90 years compared with a control group of patients aging under 90 years. Methods : This study reviewed 25 patients with CSDH aged over 90 years of age treated in our department. This group was compared with a younger group of 25 patients aged below their eighties. At admission past medical history was recorded concerning comorbidities (hypertension, dementia, ictus cerebri, diabetes, and heart failure or attack). History of alcohol abuse, anticoagulant and antiplatelet therapy, head trauma and seizures were analyzed. Standard neurological examination and Markwalder score at admission, 48 hours after surgery and 1-6 months follow-up, radiologic data including location and CSDH maximum thickness were also evaluated. Results : Their mean age was 92.8 years and the median was 92.4 years (range, 90-100 years). In older group, the Markwalder evaluation at one month documented the complete recovery of 24 patients out of 25 without statistical difference with the younger group. This data was confirmed at 6-month follow-up. One patient died from cardiovascular failure 20 days after surgery. The presence of comorbidities, risk factors (antiplatelet therapy, anticoagulant therapy, history of alcohol abuse, and head trauma), preoperative symptoms, mono or bilateral CSDH, maximum thickness of hematoma, surgical time and recurrence were similar and statistically not significant in both groups. Conclusion : In this study, we demonstrate that surgery for very old patients above 90 years of age affected by CSDH is safe and allows complete recovery. Comparing two groups of patients above and under 90 years old we found that complication rate and recovery were similar in both groups.