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Bradykinesia, Rigidity and Gait Disturbance Due to "Possible" Normal Pressure Hydrocephalus in a Patient with Anxiety and Bipolar Disorder : A Case Report (불안, 기분장애로 치료 중 보행장애 외에 서동과 강직을 동반한 정상뇌압수두증 증례)

  • Jang, Sae Heon;Jae, Young Myo;Choi, Jin Hyuk;Bae, Jung Hoon;Seong, Sang Yoon;Cho, Se Hoon;Kim, Young Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.66-69
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    • 2015
  • In addition to classical triad such as gait disturbance, urinary incontinence and dementia, parkinsonian extrapyramidal motor signs and neuropsychiatric symptoms can be observed in patients with normal pressure hydrocephalus (NPH). In our case, a 46 year old female patient showed extrapyramidal symptoms such as bradykinesia, rigidity and neuropsychiatric symptoms such as agitation, anxiety, restlessness and regressed behavior beside two(gait disturbance & urinary incontinence) symptoms of three classical triad. It was difficult to diagnose this patient as NPH from the beginning because of her relatively young age and previous psychiatric mediation history for controlling advanced anxiety and affective disorder. Antiparkinsonian agents and discontinuation of psychiatric medications did not work for this patient. Patient's brain computed tomographic finding showed enlarged ventricles. We suspected NPH and did empirical drainage of 30mL CSF. Finally, patient's pyramidal and neuropsychiatric symptoms as well as two of three classical triad of NPH were improved dramatically within several days. It is important to consider NPH as one of the differential diagnosis in patient with parkinsonian symptoms and various neuropsychiatric symptoms who did not respond to usual clinical management especially in case of ventricular enlargement in neuroimaging because of its treatable property by CSF shunt operation.

Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy (전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고)

  • Mok, Seo-Hee;Lee, Ji-Won;Lee, Tae-Jong;Seo, Jung-Bok;Kim, Kyoung-Ah;Kim, Joe-Young;Park, Byung-Jun;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.71-80
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    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.

Development and Usability Test of the Prototype of the "Smart Stacking Cone" Based on Dual-task Using ICT (ICT를 이용한 이중과제 기반의 스마트 스태킹 콘의 시제품 개발 및 사용성 평가)

  • Lim, Seung-Ju;Won, Kyung-A;Kim, Dae-Gyeom;Kim, Young;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.95-108
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    • 2021
  • Objective : This study aimed to develop prototypes of "smart stacking cones" by combining ICT to evaluate and train the upper extremity function and dual task performance in patients with central nervous system impairment, and to identify the complementary point to the completion of the device through a usability test. Methods : This prototype comprised of a hardware and software system that enabled the evaluation and training of patients and the management of data obtained from patients' performance. Specific measurement variables were established so that patient performance could be measured correctly. Based on the measurement variables, a the prototype included a 'single task evaluation modes', 'dual task evaluation mode', 'single task training mode', and 'dual task training modes'. Additionally, a usability test was conducted to assess clinical applicability and overall satisfaction for the prototype. Results : The results of the usability test were generally found to be appropriate. The 'content adequacy' in the usability test was the area with the highest level of adequacy and the lowest level of inadequacy. Additionally, overall 'satisfaction' in the usability test was the area with the highest appropriate and inappropriate levels. Hence, the overall satisfaction results were unstable. Conclusion : Future studies should be conducted to identify the clinical effectiveness of the device by applying an upgraded smart stacking cone to an actual patient group.

Association of Social Exclusion on Depression in Middle and Older Elderly: Focusing on Gender Differences (사회적 배제와 중·고령 노인 우울의 연관성: 성별 차이를 중심으로)

  • Lee, Yejin;Noh, Young-min;Kim, Jin-uk;Ha, Yeong-eun;Lee, Ju Hyun;Noh, Jin-Won
    • Journal of Digital Convergence
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    • v.17 no.2
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    • pp.293-301
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    • 2019
  • The purpose of this study is to redefine 7 social exclusion factors and to derive association between social exclusion factors and depression of middle and older elderly, focused on gender differences. The elderly aged over 50 years old were extracted from the data of the Korean Longitudinal Study of Ageing (KLoSA) in 2016. The data was analyzed by descriptive analysis, chi-squared test, and binary logistic regression analysis, using SAS 9.4. As a result, the elderly who were excluded from labor, residence, health, and relationship were found to be associated to depression. In addition, male with resident exclusion were associated with depression compared to non-excluded. Therefore, it is necessary to improve the local community programs in which elderly people can participate in labor and cultural activity. It is necessary to improve labor and culture exclusion by increasing the participation opportunities of various cultural programs. In addition, it is needed to establish specific guidelines for eliminating the social exclusion of overall elderly.

A Study on the Problems and Improvement of Long-Term Care Insurance for the Elderly (노인장기요양보험제도의 문제점 및 개선방안에 관한 고찰)

  • Ahn, Myung-Sun;Park, Joo-Hyun
    • The Journal of the Korea Contents Association
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    • v.19 no.8
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    • pp.525-534
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    • 2019
  • Korea is facing one of the fastest aging population problems in the world due to the extension of life expectancy and low birth rates due to economic development and the development of health care. It has become difficult to take care of elderly people in need of long-term care at home, and social problems such as dementia and the increase in stroke cases are serious problems. The government is enacting and implementing the Long-Term Care Insurance Act for the purpose of improving the quality of life for senior citizens subject to long-term care and alleviating the burden of family support in order to solve such social structure and problems for senior citizens. However, as a result of the implementation of the long-term care insurance system for the elderly, the privatization of the facilities and the disorder are causing widespread requests for public accountability of the services and the enhancement of the quality of the facilities. In addition, various arrangements are needed for the production of low-wage medical care workers, tasks for quality improvement, problems regarding financing methods, and so on. In order to maintain and develop the long-term care insurance system for the elderly, the government will consider seeking ways to improve the legal and institutional aspects according to changes in the social environment of the age, as well as seeking mental and psychological measures for the stabilization of old life as well as physical health.

The Trend of Overseas Studies on the Intervention of Multisensory Environment: Systemic Review (다감각환경중재에 관한 국외 연구의 경향: 체계적 고찰)

  • Cho, Eun-Hee;Song, Hyun-Eun;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.1
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    • pp.54-64
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    • 2019
  • Objective : The purpose of this study is to study the effects of multisensory environment interventions, to provide information about clinical applications, and to aid South Korean research on the multisensory environment. Methods : PubMed, Cochrane, and Google Scholar were used to search for papers published from 2008 to 2018. The main search terms were "multisensory environment" and "snoezelen", a total of 10 foreign research articles were selected. And they were summarized according to Patient, Intervention, Comparison, Outcome (PICO). Results : Among the 10 papers, 6 included participants with dementia. The other studies examined patients with intellectual disabilities, patients with schizophrenia, and pregnant women. The study periods ranged from 3 weeks to 10 months. Most of the interventions included 2 or 3 sessions per week. The duration of each intervention session was 30 to 60 minutes. The dependent variables were psychological factors (such as anxiety and depression), social factors (such as quality of life), and cognitive and physical domains. The multisensory environment used for the interventions in the studies consisted of visual, auditory, and tactile senses, as well as additional olfactory and taste sensations, and vestibular sensations. Conclusion : In the future, the research should be applied to various target groups, especially children, who are interested in multisensory environmental intervention in South Korea.

Factors Affecting Periodontal Disease in Fertile Women (가임기 여성의 치주질환 유병에 영향을 미치는 요인)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.580-586
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    • 2019
  • This study selected 2,134 fertile women aged 20 to 44 years as the final study subjects using the 6th source data of the National Health and Nutrition Survey. The purpose of this study was to investigate the relationship between female characteristics, chronic diseases and oral health behavior, and the effects of each factor on periodontal diseases. There were statistically significant differences in age(p<0.001), education level(p<0.001), income(p<0.05), marital status(p<0.001), smokes(p<0.05) and pregnancy(p<0.001). Chronic disease factors showed statistically significant differences in hypertension(p<0.001), obesity(p<0.001), diabetes(p<0.001), hypercholesterolemia(p<0.05), hypocholesterolemia(p<0.001) and hypertriglyceridemia(p<0.001). Oral health behaviors were statistically significant in terms of toothache(p<0.05), orthodontic treatment(p<0.05) and chew discomfort(p<0.05). As a result of examining the risk factors affecting periodontal disease, the risk of chronic disease was 1.576 times higher in the obese group, and 2.569 times higher in the diabetic group than in the normal group. The subjective oral health status was 1.372 times higher for normal women and 1.614 times higher for bad women than for good ones. As a result, diabetes has shown the greatest risk among chronic diseases in women, and diabetes and obesity are highly relevant and therefore are considered important variables for the risk factors of dementia. In this regard, it is necessary to examine the risks of chronic and periodical diseases, expand oral health education programs for women's dental disease, and prepare oral health policies.

A Study on the Determinants of the Incidence and the Transition of Older Adult Disability: Findings from the Korea Longitudinal Study of Aging(KLOSA) (노년기 장애발생과 장애정도의 변화에 미치는 영향요인 연구: KLOSA 1차와 2차 자료를 중심으로)

  • Koo, Bonmi;Seok, Jae Eun
    • 한국노년학
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    • v.32 no.4
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    • pp.993-1011
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    • 2012
  • The purpose of this study is to investigate the factors associated with the incidence and the transition of disability among Korean older adults. Samples consist of 1,454(42.7%) men and 2,032(58.3%) women aged 65 and over who participated in the 1st and 2nd wave of the Korea Longitudinal Study of Aging: KLOSA. To estimate the level of disability, ADL and IADL disability indexes are used. As the results, major risk factors for ADL/IADL disability incidence include injury, vision problem, cognitive function, depression, health behavior, socioeconomic characteristics and age. Among the normal older adults, the odds ratio of having dementia symptoms at 2nd wave(2008) are 2.0 times greater for the older adults who have less cognitive function than those who don't have at 1st wave(2006). Among the older adults with chronic diseases, the odds ratio of having disability at 2nd wave are 1.8 times greater for the older persons who have depression than those who don't have at 1st wave. Secondly, concerning the predictors affecting the disability transition among the disabled older adults at 1st wave, the likelihood of remaining at the same level or deteriorating the level of IADL disability, as compared with improving the level, is associated with having less instrumental support or being older. These results indicate that it is necessary to prefer multilevel intervention in order not only to prevent the incidence of disability, but also to prolong the deterioration of disability in the older adults.

Association between masticatory ability, oral health-related quality of life and cognitive function in the elderly population using structural equation modeling (구조방정식을 이용한 대도시 일부 노인들의 저작능력 및 구강건강관련 삶의 질과 인지기능)

  • Shin, Hae-Eun;Chang, Ic-Jun;Cho, Min-Jeong;Song, Keun-Bae;Choi, Youn-Hee
    • Journal of Korean Academy of Oral Health
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    • v.42 no.4
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    • pp.159-166
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    • 2018
  • Objectives: The aim of this study was to investigate the association between masticatory ability, oral health-related quality of life, and cognitive function in an elderly population using structural equation modeling. Methods: A total of 308 subjects, aged 65 years and over, were recruited from the senior citizen center in Daegu, South Korea and provided consent for inclusion in the study. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to assess the level of cognitive function. Masticatory ability was evaluated through chewing tests, patient-perceived masticatory function and, measurement of relative occlusal forces on molar teeth using the T-Scan $III^{(R)}$ system. All data were analyzed using ${\chi}^2$ tests, t-tests, and one-way ANOVA in SPSS version 23.0 for windows. Structural equation modeling was performed using SPSS AMOS version 22.0. Results: There was a significant association between cognitive function and molar teeth occlusal force. Ability of food chewing score and patient-perceived masticatory function could affect oral health-related quality of life (P>0.05). Higher occlusal forces on molar teeth, compared to anterior teeth, positively correlated with higher cognitive function. Conclusions: These results suggest that an individual's oral health condition could affect molar teeth occlusal forces and may be related to a risk of developing dementia. Therefore, there is a need for implementing nation-wide policies to improve oral health, such as masticatory function, in the elderly population.

Establishing EMG Measurement System for Measurement of Motor Nerve Response in Transcranial Magnetic Stimulation (경두개 자기자극 시 운동신경 유발응답 측정을 위한 근전도 측정 시스템 구축)

  • Lee, Geun-Yong;Kim, Su-Hwan;Jo, Jae-Hyun;Yoon, Se-Jin;Lee, Sang-Sik
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.12 no.4
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    • pp.413-418
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    • 2019
  • Studies are now actively underway to confirm the degree of treatment and rehabilitation of patients with brain-related diseases (dementia, schizophrenia, depression, Parkinson's disease). Among them, Transcranial magnetic stimulation (TMS) is widely used in treatment because it is a technique that is used for noninvasive brain neuron control in patients with brain disorders. It can be seen that muscle fatigue of normal people increases during Transcranial magnetic stimulation. Therefore, in this paper, our purpose is to build an EMG measurement system to measure motor neuron-induced response during transcranial magnetic stimulation and We identify a motor-neutral response system using tendency in the RMS graph. As an experimental method, the Raw Data received through the surface EMG device and analyzed by RMS technique, after the contraction and relaxation movement of the biceps brachii. As a result of the experiment, we confirmed the trend of rising RMS graph, and it will can be used to determine the self-stimulation intensity for each individual in consideration of the data of the motor-neutral response.