• 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.

• Journal of the Korea Convergence Society
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• v.9 no.8
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• pp.265-272
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• 2018

This study is a descriptive study to investigate the factors influencing the level of cognitive function among elderly living alone according to the presence of dementia risk factors. We conducted a simple questionnaire, GDS-K and MMSE-DS tests to investigate the risk of dementia among 143 elderly people living alone in the community. The results showed that the major factors influencing the cognitive function of the elderly people living alone were education, age, depression status, smoking, leisure activities, and gender. In order to develop strategies for the prevention of dementia in the elderly people living alone, it is necessary to change lifestyle and provide various management methods to identify risk factors that negatively affect cognitive function and to help cognitive health.

• Journal of Korean Public Health Nursing
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• v.19 no.2
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• pp.371-381
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• 2005

Purpose: The purpose of the study was to develop the day care program for the demented elders and to determine the effects of multiple activity therapies on the physical, emotional, cognitive, social function and physiological indicators of dementia elders in day care center. Method: A total of 13 elders with mild dementia in the data care center were participated. Manual and guideline of data care program was developed. Data care program was composed of movement/exercise, foot massage, music therapy, horticultural therapy, and art therapy. Data care program was performed by trained intervener for 32 weeks. Instruments were physical functioning such as hand grip strength., vital capacity, chiar stand test, sit and reach test, one leg standing, Berg' Balance scale, 6m Walk Velocity, stair climb, ADL, GDS-K, MMSE-K, Integrative Social Functioning Scale, cortisol, Ig A and Ig G. These were measured at the baseline, 16-week, and 32-week post-intervention by the trained nurses. Data were analyzed as Wilcoxon signed rank test. Results: For Hand grip, balance, and vital capacity, there was a significant difference between baseline and 16-week post-intervention(p<.05). For one leg standing, 6m velocity, there was a significant difference between 16-week post-intervention and 32-week post-intervention(p<.05). For Stair climb, there was a significant difference between baseline and 32-week post-intervention(p<.05). For depression and social functioning, there was no significant difference among baseline, 16-week, and 32-week post-intervention. For cognitive functioning, there was a significant difference between baseline and 32-week post intervention(p<.05). There was a significant difference of cortisol, and Ig G between baseline and 32-week post-intervention(p<.05). Conclusion: It would appear that physical fitness, functional performance, ADL, depression, social and cognitive functioning, and physiological indicator of community dwelling elders with dementia can be improved through day care program using multiple stimuli.

• Korean Journal of Community Nutrition
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• v.17 no.6
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• pp.772-781
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• 2012

In order to supply the reference data to define the quality of life of the rural agricultural elderly population in the simplified steps, the data were collected by personal visits to 232 elder people over 65 (89 males and 143 females) in Sunchang area. The survey was conducted with written questionnaires concerning the quality of life, health-related habits, basic physical functions and cognitive behavior. The prevalence of the degenerative diseases were assessed by anthropometric and biochemical determinations. The averaged overall quality of life represented by EQ-5D index with Nam's model was calculated to be $0.865{\pm}0.1509$, and the percentages of people below the average were 38% (low QOL group) and 62% (high QOL group) were found to be the above the average. Generally, the subjects with male gender, higher educational background, higher self-rated health status, higher social activities were belonged to the high QOL group. The high QOL group had higher scores of daily living activities KADL and IADL, and lower risks in cognitive functions K-MMSE and depression scale GDS. There was no statistically significant correlation between biochemical indexes of blood and cognitive function and EQ-5D scores when the results were adjusted for age and gender. There were significant differences in nutritional assessment determined by the MNA between the high and low QOL groups. The low QOL group showed inferior nutritional status. The rapidly measurable factors of the quality of life of rural elderly were turned out to be physical activity scores and the simplified nutritional status measurement.

• PNF and Movement
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• v.17 no.1
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• pp.69-79
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• 2019

Purpose: This study aims to investigate the effects of a group computerization cognitive rehabilitation program on cognitive function in patients with cognitive impairment. Methods: The subjects of this study comprised 34 patients with cognitive impairment (15 males and 19 females) who were randomized into two groups. The experimental group (n = 17) were trained with the group computerization cognitive rehabilitation program, while the control group (n=17) received traditional cognitive therapy. The interventions for both groups were performed for 1 hour per day, once a week for 12 weeks. The cognitive functions of the subjects before and after the experiment were measured using the Korean mini-mental state examination (K-MMSE), global deterioration scale (GDS), clinical dementia rating (CDR), and Lowenstein occupational therapy cognitive assessment (LOTCA). A paired t-test was conducted to examine the intragroup differences before and after the experiment, and ANCOVA was performed to check intergroup differences. Results: The intragroup comparison results showed that the cognitive function of the group that were trained with the group computerization cognitive rehabilitation program improved after the experiment more than for the group that received traditional cognitive therapy. The intergroup comparison results showed significant differences in orientation, visual perception, and visuomotor organization between the two groups. Conclusion: The results of this study confirmed that the group computerization cognitive rehabilitation program was more effective in improving cognitive function than the traditional cognitive therapy in patients with cognitive impairment. Based on the results of this study, the group computerization cognitive rehabilitation program can be used as an effective intervention method for patients with cognitive impairment.

• Journal of Family Relations
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• v.21 no.3
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• pp.49-72
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• 2016

Objectives: The purpose of this study is to develop a cognitive behavioral therapy program for ego-integrity of depressed elderly women living alone, and to verify its effectiveness. Method: The subjects of this study were composed of elderly women(age 65 and older) living alone who had basic literacy skills, 24 or higher in mental state examination(MMSE-K), and 6 or higher in elderly depression(GDS). 29 women were randomly assigned into an experimental group(cognitive behavioral therapy), a comparison group(reminiscence therapy) and a control group. The experimental group and the comparison group retrospectively participated in a 90-minute therapy session twice a week for a total of 12 weeks. The effectiveness of the program was assessed through a pretest, posttest, and 2-month follow-up test. The data collected were analyzed with SPSS 22.0 statistical program. Results: The main findings of this study are as follows. First, at posttest ego-integrity and self-esteem marked higher scores in both of the experimental group and the comparison group than in the control group, but the experimental group marked comparatively higher scores than the comparison group. For dysfunctional attitude, only the experimental group showed lower scores compared to the comparison group and the control group. Second, at posttest depression marked lower scores in the experimental group compared to the comparison group and the control group. Third, at posttest problem-solving and support-seeking coping strategies marked higher scores in the experimental group compared to the comparison group and the control group. Fourth, the significant improvements remained at 2-month follow-up test. Conclusions: Cognitive behavioral therapy resulted in improvements of the ego-integrity and related symptoms of depressed elderly women living alone at posttest and 2-month follow-up test respectively.

• Journal of Oriental Neuropsychiatry
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• v.28 no.3
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• pp.263-274
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• 2017

Objectives: To identify the current status of Korean medical practice pattern, diagnosis and treatment of dementia through recognition survey, and to use it as a preliminary data for various dementia research. Methods: Questionnaires were developed through expert meetings. The disease was defined as dementia and mild cognitive impairment, and areas were designated to practice pattern, diagnosis and treatment. From December 18, 2016-January 18, 2017, 221 respondents, including 36 neuropsychiatrists of Korean Medicine and 185 general physicians (including other medical specialists) were included. Results: 1. In both groups, the most commonly used KCD (Korean standard classification of disease and cause of death) were in the order of Unspecified Alzheimer's Dementia (F00.9), Mild Cognitive Impairment (F06.7), and Unspecified Dementia (F03). 2. The most commonly used pattern identification were zang-fu and qi-blood-yin-yang in both groups. 3. Diagnostic evaluation tools were mainly conducted by MMSE, radiologic examination, K-DRS, GDS and CDR in both groups. 4. Both groups reported using acupuncture and herbal medicine mainly. 5. In both groups, the acupuncture method was used extensively in the order of Body, Scalp, and Sa-Am. 6. Neuropsychiatrists used a variety of herbal medicines such as Wonjiseokchangpo-san (Yuanzhushichangpu-san), Yukmijihwang-tang (Liuweidihuang-tang), Palmijihwang-won (Baweidihuang-won), Sunghyangjungki-san (Xingxiang Zhengqi-san) and Ondam-tanggami (Wendan-tangjiawei). General physicians used a variety of herbal medicines such as Ondam-tanggami (Wendan-tangjiawei), Bojungikgi-tang (Buzhongyiqi-tang), Yukmijihwang-tang (Liuweidihuang-tang). 7. Neuropsychiatrists used a variety of Korean herbal preparation products (benefit and non-benefit) such as Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Yukmijihwang-tang (Liuweidihuang-tang), Jodeung-san (houteng-san), Palmijihwang-won (Baweidihuang-won). General physicians used a variety of Korean herbal preparation products such as Bojungikgi-tang (Buzhongyiqi-tang), Banhabaegchulcheonma-tang (banxiabaizhutianma-tang), Yukmijihwang-tang (Liuweidihuang-tang), Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Palmijihwang-won (Baweidihuang-won). Conclusions: By confirming awareness of Korean medical doctors treating dementia in clinical fields and understanding differences between neuropsychiatrists of Korean medicine and general physicians, it can be used to understand guideline users' needs and confirm clinical questions during development of future clinical practice guidelines for dementia.

• 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 Oriental Neuropsychiatry
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• v.29 no.2
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• pp.111-119
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• 2018

Objectives: To investigate the characteristics of patients diagnosed with dementia or mild cognitive impairment who are treated by means of a blend between Western and Korean medicine. Methods: We searched for outpatients with dementia or mild cognitive impairment by means of a collaboration between Western and Korean medicine from August 1, 2015, to July 31, 2017, through electronic medical records in Wonkwang Hospital. The records were retrospectively analyzed according to the patients' demographic and clinical characteristics, pathway of medical care, diagnostic tests, treatment, and medical expenses. Results: Thirteen patients were included in the analysis. Among them, six patients were diagnosed with mild cognitive impairment, five with dementia, Alzheimer's type, one patient with frontotemporal dementia, and one patient with unspecified dementia. Twelve of the thirteen patients were over 60 years of age. The number of pathways from the Dept. of Neurology to the Dept. of Neuropsychiatry of Korean Medicine was almost the same as the opposite pathway. The most used diagnostic test in Korean medicine was a neuropsychological test such as SNSB, MMSE and GDS. In Western medicine, hematology and neuroimaging were frequently used for patients. Acupuncture in Korean medicine and medication in Western medicine were the most frequently used. In Korean medicine, uncovered service costs were much higher than covered service costs,. whereas, in Western medicine, covered service costs were higher than uncovered service costs. Conclusions: This study describes the basic characteristics of dementia and mild cognitive impairment patients treated by a collaboration between Western and Korean medicine. Based on these results, a clinical pathway of the collaborative practice system between Western and Korean medicine for dementia patients needs to be developed.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.783-786
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• 2015

Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.